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To: Permit Department Page 5 of 7 2016-02-25 21:26:50 (GMT) 18884000383 From: Deborah Shields <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 8817 EMERSON PL 00482500004000 <br /> 7 <br /> LEGAL LOT NO, <br /> BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> DARLENE ROSENQUIST 8817 EMERSON PL Everett 98208 425-418-5188 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> INaida Khan 300-945-2737 <br /> CONTRACTOR Washington Energy Svcs Co, LLC ADDRESS CITYIZIP PHONE <br /> 3909 190th St SW Lynnwood 800-398-4663 <br /> CONTR.LICENSE#WAS�"fIEsCC??�y51 �S <br /> USE OF BUILDING [ HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR _Electric Gas—Other 3614.05 <br /> WORK DESCRIPTION <br /> REPLACE ELEC FURNACE <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO., TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub 1 Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> Uigi[aity signetl by Naida khan <br /> h '�DN:cn<:,Naida Rhare,b•=Northwest Permit <br /> 1\�a i d es R h r�^ `:Inc.ou,enail�n.aida<anwpr..rrrur..c.nrn, <br /> Signature bf e tr c r r4fizpitisAgent Date <br /> Date;2G 1 ti.0215 13:10:38-08'CO' <br />