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To: E Page 2 of 4 2015-12-09 13:13:45 (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 <br />2029 WAt�NUT ST #3 <br />LEGAL LOT NO. BLOCK <br />DESC. <br />PARCEL TAX I.D. # <br />005632412001�0 <br />TRACT <br />r'�Y� <br />CITYIZIP PHONE <br /># <br />� <br />S�-iELBY CAMPE3ELL 2029 WALNl1� ST #3 �verett 9s2o� 4��_3�7-3t79� <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />(Naida Khan 360-945-2787 <br />CONTRACTOR Washinc�ton En�rgy Svcs Co, ��C ADDRESS CITY/ZIP PHONE <br />3909 196th St SW Lynnwot�d 80CI-398-4663 <br />CONTR. L{CENSE # � R�A�H I ES��J � f V J <br />VV <br />USE OF BUILDING <br />TRI PL.EX <br />WORKDESCRIPTION <br />�fl5fa�� dUC�18S5 ii@�f pLlii1� <br />NO. <br />PLUMB(NG <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/ba�/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountairt <br />Fioor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT SOURCE <br />� Electric _ Gas _ Other <br />NO <br />� <br />CONTRACT PRICE OF WORK <br />I... .� <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />I A/C — air handling units <br />� Forced air systems <br />'i Gas piping <br />' Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refngeration <br />Woodstove <br />Other <br />C13Y OF EVERETT LOCAL SALES TAX CODE IS 3905 <br />I hereby ceritify that 1 have read and examined this application and know the same to be true and correct. Afl provisions of laws and <br />ordnaces goveming 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 stats or local law regulating construction or the performance of <br />construction. That i am authorized by fhe owner of this property to perform the work for which application is made and I comply with the <br />State Contr��' �'� � R��,4��ti,�n/ and 296200 WAC. <br />�;� .--.. �. j�1� C artally ��qn2r D,v J= v� r� nvaU <br />� r . t fY}ra�� DNcn—J�r�n'f�r�o�.�l .��,u.au._�n�Afc ..,rwperrr�,corn.c—US <br />��' "��•`�"" �' ��t�:[C�L i2. ROS: 15E U2'CO' <br />,4, !; � ���, � � r <br />Signature o'i=vwnc�i�ui�«aciu�`ii�'uthorize �gent Date <br />�' �� �� <br />