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To: E Page 4 of 15 2015-09-24 22:17:56 (GMT) 18884000383 From: Deborah Shields <br /> 0 0 <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 f � <br /> 9910 EVERGREEN WAY 28041300302700 I ' ' — 6� <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> WILLIAM TACKITT 9910 EVERGREEN WAY Everett 360-863-3791 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> INaida Khan 360-945-2787 <br /> CONTRACTOR Washington Energy SVCS Co, LLC ADDRESS CITY/ZIP PHONE <br /> 3909 196th St SW Lynnwood 800-398-4663 <br /> CONTR.LICENSE#WAS H I ES851 NS <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR —Electric Gas—Other 8500 <br /> WORK DESCRIPTION <br /> REPLACE GAS WATER HEATER. <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 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 Contra t�rg I aW and 296D? WAr <br /> ig�a y"g— yJFrmifer Covello <br /> .y{ DN:cn=Jcnni cr Covcllo,o,ou.cmad=jenniferu9nwpermil.com. <br /> Signature a wvv idl urlud� llf uthodz6d gen Date <br />