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To: E Page 1 of 7 20'16-01-09 21:14:22 (GMT) 18884000383 From: Deborah Shields <br />PERM IT APPLICATION <br />CITY OF EVERETT PERMiT SERVICES <br />320a 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 />51TE ADDRESS <br />1711 RUGKER AV� <br />LEGAL LOT NO. BLOCK <br />DESC. <br />PARCEL TAX I.D. # <br />aa4�aoa45oa�ao <br />TRAC7 <br />oWNER ADQRESS CITY/ZIP PHONE <br />DAWN � SITTAUER 1711 RUCKER AVE Everett 425-259-4350 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />Naida Khan 3�U-945--2787 <br />CONTRACTOR ��shington Energy Svcs Go, f_1_C '�'D�RESS CITY/ZIP PHONE <br />3909 196th St SW Lynnwood 800-398-4663 <br />CONTR. LICENSE # WAS H( E�7U5 � N S <br />USE OF BUILDING <br />S F �2 <br />WORK DESCRIPTION <br />REPLACE GAS WATER HEATER. <br />NO. <br />PLUMBING <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 />5ink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT SOURCE <br />Electric � Gas _ Other <br />NO. <br />CaNTRACT PRICE OF WQRK <br />750.�i0 <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />I A/C — air handling units <br />' 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 />Fieat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstave <br />CITY OF EVERETT LdCAL SALES TAX CO�E IS 3105 <br />I hereby ceritify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br />ordinaces 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 state or local law regulating construction or the perform�nce 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 />5tate Contr ;, � �� and 296.200.��igned by lenri'erLovel!o <br />�: ( ���� ; DN:.n=Jenr(€rCovelo,o_eu,emad=jennifer��;nwperm,l.con-�, <br />� —� � �,4 i.s. �,r�i �� e�� US <br />� � � ,,..: ,> �.�,'r,1� ]0 E a' 0_aS�AS-�n'"`�' <br />. .. s3�a�,�-_ n.�.�� i a i i� <br />re o�"vwi��t:i��,u��u�ci�rir�`"Uinonzed Ayent Date <br />��k��'i <br />