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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:7909 EV6f9f@@Ct PROPERTY TAX#:28050700306600
<br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description)
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<br /> OWNER NAME: EV2t'CJI'@@Il BUC'CJ LLC TENANT NAME(If Commercial): LOI1qIlOC'fl R@StaUCatlt
<br /> OWNER MAILING ADDRESS: srReer 7909 Evergreen Way
<br /> �,n Everett STATE WA z�P 98203
<br /> OWNER PHONE:2067990177 OWNER EMAIL:
<br /> CONTRACTOR NAME:WASHINGTON ENERGY SERVICES
<br /> CONTRACTOR ADDRESS: srReer 3909 196TH ST SW
<br /> o,n LYNNWOOD STATE WA Z,P 98036
<br /> CONTRACTOR PHONE:ZO6-37S-6644 CONTRACTOR EMAIL:VSt2pI1@t1S011 G�WaSI1lClgtOfl@tl@gy.COt71
<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:2Q(�j-37$-664tI�
<br /> Vanessa Stephenson CONTACT EMAIL:vstephenson@washingtonenergy.com
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<br /> Existin Use of Buildin : Contract Price of Work:$ssoo
<br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other
<br /> Buildin T e: OSFR-Detached �SFR-Attached mu lex �Multi-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 /> Replacing gas water heater, like for like.
<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 ust of Fixtures #�f List of Fixtures #of (;st of Fixtures #of List of Fixtures
<br /> Fixtures Fixtures Fixtures Fixtures
<br /> A/C—Air Handlin Units Heat Pump Toilet Backflow Preventer(Inside Bld
<br /> Forced Air S stems Unit Heater Bathtub Urinal
<br /> Gas Pipin Boiler Lavato (Wash Basin Drinkin Fountain
<br /> � Water Heater Refri eration Shower Floor Drain
<br /> Gas Fire lace 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/Bar/Mo /etc. Other:
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<br /> Number of Heads
<br /> ACKNOWLEDGEMENT.�I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with
<br /> current federal,state,and/oca/law.The granting of a permit onty authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the
<br /> Building Official before being authorized under any circumstance.1 am the owner,or/am authorized by the owner of this property to perform the work for which application is made,
<br /> and I comp/y with the State Contractors Law 18.27 RCW and 296.200A WAC.
<br /> City of Everett Officia/Use On/y
<br /> PERMIT# '
<br /> Ethan Onat �-�—�-w«•����a� os12s/17 ��� �� �� ������,�
<br /> Owner/Authorized Agent Signature � Date (Revised 10/12/2015)
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