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To: E Page 15 of 16 2015-11-10 '18:49:15 (GMT) 18884000383 From: Deborah Shields <br />SITE RDDRESS <br />1823 STATE ST <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />TRACY A SUBLETT <br />TENANT NAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C�DAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APP�ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX i.D. # <br />00563235400500 <br />BLOCK TRACT <br />1823 STATE ST <br />CON7ACT FOR PERMIT <br />Naida Khan <br />coNT�AcroR Washington Energy Svcs Co, LLC ADDRESS <br />3909 196th St SW <br />coNrR. �iceNse # WAS H I ES851 N S <br />USE OF BUILD#NG <br />SFR <br />WORK DESCRIPTtON <br />REPLACE GAS WATER HEATER. <br />NO. <br />r�vsnon�v <br />TYPE OF FtXTURE OR ITEM <br />Toilet <br />Bathtu b <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backfiow preventer <br />Urinai <br />Drinking Fountain <br />Fioor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT SOURCE <br />_ Electric � Gas _, Other <br />� <br />� <br />CITY/ZiP <br />Everett 98201 <br />PERMIT # <br />'V1 I �1 I - (� � <br />PHONE <br />425-257-3164 <br />PMONE <br />36(J-945-2787 <br />CITYlZiP PHONE <br />Lynnwood 800-398-4663 <br />CONTRACT PRICE OF WORK <br />750.00 <br />iVlCVtiHIVi <br />TYPE OF FIXTURE OR {TEM <br />;' A/C — air handling units <br />'i Forced air systems <br />'� Gas piping <br />' Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Neat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE tS 3105 <br />a <br />I hereby ceritify that 1 have read and examined this applicafion and know the sarne to be true and correct. Alf provisior�s of laws and <br />ordinaces goveming this type of work will be complied with whether specified herein or not. The graniing of a permit does nof presume <br />to give authority to violate or cance! the provision of any ather state or locai law regulating construction or the performance of <br />construction. That i am authorized by the owner of this properry to perform the work for which appiication is made and i comply with the <br />Staie �'nnt��c-��rc I a�i 9�i �7, �r't�1 �n�1296.200 WA�. <br />;� <br />� �': Digita y slgned by Jennifer Covell� <br />p `�� h <br />��, k °y,,, ;k �� r t �`; DN: cn=Jennifer Covello, o, ou, <br />, � Date:2015.11,101033:11 -OS'00' <br />