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PERIT APPLICATION <br /> BUILDING/ M CHANICAL I PLUMBING I SIGN I SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> �a��E g; -.7�# . RT INFO -TIIOIRN „u t l' i a\ a <br /> �tiF..,� s�"'��.?.,.® al� vawv ..>...... � � ..- ,,.-.'. .=�:a-�\,.,�era?, <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: <br /> 2822 Larlin Dr 00603700007600 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NAME: Benjamin Young TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET2822 Larlin Dr <br /> C,n Everett STATE WA ZIP 98203 <br /> OWNER PHONE:206-715-1124 OWNER EMAIL: <br /> CONTRACTOR NAME:WASHINGTON ENERGY SERVICES <br /> CONTRACTOR ADDRESS: STREET 3909 196TH ST SW <br /> CITY LYNNWOOD STATE WA ZIP 9803. <br /> CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL:vstephenson@washingtone '•gy.Co <br /> CONTRACTOR LICENSE#(REQUIRED):WASH IES85I NSCITY OF EVERETT BUSINESS LICENSE#(REQUIRE!54773 <br /> PRIMARY CONTACT: ❑OWNER E CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-378-6648 <br /> Vanessa Stephenson CONTACT EMAIL:vstephenson@washingtonenergy.com <br /> Existing Use of Building: Contract Price of Work $4200 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Elec ric ❑Other <br /> Building Type: ✓❑SFR-Detached ❑SFR-Attached muplex ❑Multi-Family-#of Units: ['Commercial ❑Industrial <br /> Type of Project: ONew ❑Addition ❑Remodel ❑Repair CT.!. ❑Sign ❑Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Installing a tankless water heater <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> P.:rralir...,.. PPI:OAt gi h ' (/pti,,,.` G'PERMIT . - -.w, ,. aON ., a- <br /> rrr <br /> Type of Project: _New _ Addn Q Alteration _Repair Type of Project: _New _Addn ••Iteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units —Heat Pump -Toilet —Backflow Preventer Inside Bid.) <br /> Forced Air S stems —Unit Heater —Bathtub _Urinal <br /> Gas Pipin. Boiler ®Lavato (Wash Basin Drinkin. Fountain <br /> 1 Water Heater Refri•eration ®Shower —Floor Drain <br /> Gas Fireplace _Wood Stove —Kitchen Sink&Disposal —Grease Trap <br /> Gas Ranee —Ductin• _Dishwasher —Roof Drains <br /> Clothes D er Hooku•s —Other: —Clothes Washer —Medical Gas <br /> Ranee Hood —Water Heater —Other: <br /> Exhaust Fan ®Sink Service/Bar/Mo./etc. —Other: <br /> 1111111a,*1110041000Paz, ::,:;:!:,11;:,; x r I <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 local law.The granting of a permit only 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett <br /> Official Use Only <br /> Vanessa StephensOn gpo.°zd �� ne'n 12/29/17 ~01eQ <br /> 1 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />