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PERMIT APPLICATION
<br /> BUILDING/ MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits
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<br /> PROJECT SITE ADDRESS:2030 Gfalld AV@#3 PROPERTY TAX#:01092900000300
<br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description)
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<br /> OWNER NAME: Cal'OI Wlllt@I12aC� TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sTReer2030 Grand Ave#3
<br /> �,n Everett STATE WA Z�P 98201
<br /> OwNER PHONE:425-359-2618 OWNER EMAIL:
<br /> CONTRACTOR NAME:WASHINGTON ENERGY SERVICES
<br /> CONTRACTOR ADDRESS: sTReer 3909 196TH ST SW
<br /> cirY LYNNWOOD STATE WA ziP 98
<br /> CONTRACTOR PHONE:2OG-37H-B644 CONTRACTOR EMAIL:VSt@plleflSOt1 p�WaSlllftgtOtl@ y.CO
<br /> CONTRACTOR LICENSE#(REQUIRED):WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54773
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<br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:2Q6-37$-66t�4
<br /> Vanessa Stephenson CONTACT EMAIL:vstephenson@washingtonenergy.com
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<br /> Existin Use of Buildin : Contract Price of Work $5oso
<br /> Proposed Use of Buildin : Heat Source: ❑Gas ❑Ele ric ❑Other
<br /> Buildin T e: ✓❑SFR-Detached ❑SFR-Attached mu lex OMulti-Famil -#of Units: ❑Commercial ❑Industrial
<br /> T e of Pro'ect: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use
<br /> DESCRIPTION OF WORK:
<br /> Installing a tankless water heater with gas piping.
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
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<br /> Type of Project: _New Addn ✓ Alteration _Repair Type of Project: _New Addn Iteration _Repair
<br /> #of List of Fi�ures #of ust of Fixtures #of �ist of Fixtures #of List of Fixtures
<br /> Fixtures Fixtures Fixtures Fiartures
<br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bid
<br /> orced Air S stems Unit Heater Bathtub Urinal
<br /> � as Pipin Boiler Lavato (Wash Basin) Drinkin Fountain
<br /> � ater Heater Refri eration Shower Floor Drain
<br /> as Fireplace Wood Stove Kitchen Sink&Dis osal Grease Trap
<br /> Gas Ran e Ductin Dishwasher Roof Drains
<br /> Clothes D er Hooku s Other: Clothes Washer Medical Gas
<br /> Ran e Hood Water Heater Other:
<br /> Exhaust Fan Sink Service/BaNMo /etc. Other:
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<br /> ACKNOWLEDGEMENT.�!have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comp/y with
<br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must�rst be authorized in writing from the
<br /> Building Official before being authorized under any circumstance.l am the owner,or I am authorized by the owner of this property to pe�form the work for which application is made,
<br /> and I comply with the Sfafe Contractors Law 18.27 RCW and 296.200A WAC.
<br /> City of Everett Official Use Only
<br /> PER� �� -�z Z
<br /> Vanessa Ste hensOn 'D1p""""B"�by1anea51phena0n o2/07/18
<br /> P m�e:za,e.az.o�,o:,5:��
<br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015)
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