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To: E Page 6 of 8 2015-11-13 20:21:51 (GMT) 18884000383 From: Deborah Shields <br /> 0 .dn� <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.# PERMI <br /> 3012 VICTOR PL 00553100500500 t � <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> JESSICA MOROSO 3012 VICTOR PL Everett 98201 425-512-6005 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Naida 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# �y ft S u I C S p G 1 A I c <br /> USE OF BUILDING V/-1 1 L_ UJ I V J HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR Y—/ Electric _Gas_Other 4309.00 <br /> WORK DESCRIPTION <br /> INSTALL HEAT PUMP <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/barfmop/etc) Exhaust fan <br /> Backflow pre enter 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 /> ordinates 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 Contractors Law 18.27 RCW and 296.200 WAC. <br /> � Wil, CN c�cnnifcr lovcllo o.o,;email-jcrnifa;mvpermtomc-_> <br /> .Signature o t , uthorized Agent Date <br /> �4 0� <br />