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To: E Page 2 of 6 2015-09-29 17:19:36 (GMT) 18884000383 From: Deborah Shields <br />SITE ADDRESS <br />1005 93RD ST SW <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />BOB HAWK <br />TENANT NAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320Q CEDAR STREET, EVER�TT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />PARCEL TAX I.D. # <br />OQ5340000Q1300 <br />BLOCK TRACT <br />1005 93RD ST SW <br />CONTACT FOR PERMIT <br />Naida Khan <br />PERMIT # <br />�i� <br />CiTY/ZIP PHONE <br />Everett 425-244-9034 <br />PHONE <br />360-945-2787 <br />coNrR,acroR �ashington Energy Svcs Co, LLC ADDRESS CITYlZ1P PHONE <br />3909 196th St SW Lynnwood SOQ-398-4663 <br />coNrR. LacENSE # WAS H I ES$51 N S <br />USE OF BUIL�iNG <br />SFR <br />WORK DESCRIPTtON <br />REPLACE GAS WATER HEATER <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8� disposai <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (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 _ Ofher <br />CONTRACT PRICE OF WORK <br />950.a0 <br />ICAL <br />NO. ( TYPE OF FiXTURE OR ITEM <br />A/C – air handling units <br />Forceci air systems <br />Gas piping <br />� Water heater <br />Gas firepface <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiier <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I her�hy ceritify that I have read and exarnined this appiication and know the sarne to be true and correct. AI! provisior�s of Iaws and <br />ordinaces governing this type of work will be compiied with whether specified herein or not. The graniing of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or locai 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 1£3 27 RCW and 296.200 WAC. <br />,�US <br />:n�" �' ' ° ���+j� . UlgiCallysignedbyJennlTcri.ovello <br />�4 �;-�y { � �i�, '�.DN.<n�.Jennl�erCovrllo,<r,n' em�il-�:enrlitvr�;nwpFrmi[.roln,(�w�US <br />:'�'C _ ���"'�i�;'j �6e1 t01;.092910,02:�4-07'UO' <br />Signa—tu o Owner/Gontractor/Authonzed Aqent Date <br />