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• PERMIT APPLICATION 11111 -4. <br /> BUILDING /MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> MI 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 4706 Glenwood Ave PROPERTY TAX#: 00505700003905 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Christopher Connair TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4706 Glenwood Ave <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE: (937)305-5812 OWNER EMAIL: ccconnair@gmail.com <br /> CONTRACTOR NAME: Smart Energy Today <br /> CONTRACTOR ADDRESS: STREET 1001 Cooper Point Rd SW <br /> Olympia 98502 <br /> CITY STATE WA ZIP <br /> CONTRACTOR PHONE: 360-637-4343 x 2226 CONTRACTOR EMAIL: heidi.p@smartenergytoday.net <br /> CONTRACTOR LICENSE#(REQUIRED): SMARTET869RJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):052463 <br /> PRIMARY CONTACT: 0 OWNER ©CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-637-4343 x 2226 <br /> Heidi Paschal CONTACT EMAIL: heidi.p@smartenergytoday.net <br /> BUILDING PERMIT APPLICATION' <br /> Existing Use of Building: Single Family Residence Contract Price of Work:$ 3500 <br /> Proposed Use of Building: Home Heat Source: ❑Gas DElectric El Other <br /> Building Type: ❑SFR-Detached 0SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ID Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> -Y_ WV-3CA t RN S,00,411 X v Cl`— <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT,APPLICATION PLUMBING,PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration Repair Type of Project: _New Addn _Alteration _Repair <br /> #of #of List of Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION,SYSTEM __ <br /> Chemical or Water ( No.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.I am 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 Official Use Only <br /> 24:011/4/ ,puttj <br /> P MIT# <br /> 411.-11 11,0 1 q OS ili•••CD 4.-6 <br /> O r/ uthorized Agent Signature Date (Rev, d 9 23/2016) <br />