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To: E Page 1 of 3 20'15-'11-23 20:38:05 (GMT) 18884000383 From: Deborah Shields <br />SITE ADDi2ESS <br />10012 4TH AVE W <br />LEGAL LOT NO. <br />DESC. <br />�WNER <br />PERMIT APPL�CATION <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 />APP�ICATIOtVS ARE ACCEPTED �ROM 8 AM TO 4 PM <br />BLOCK <br />TRITEX REAL ESTATE ADVISORS II INC <br />TENANT NAME <br />PARCEL TAX I.Q. # <br />28042400201900 <br />TRACT <br />AUL7FZtS5 <br />10012 4TH AVE W <br />CONTACT FOR PERMIT <br />Naida Khan <br />ERMIT # <br />l � J" ' <br />/ZIP PHONE <br />Everett 253-954-8618 <br />PHONE <br />360-945-2787 <br />coNrRacroR Washington Energy Svcs Co, LLC ADDRESS CliYlZIP PHONE <br />39�9 196th St SW Lynnwood 800-398-4663 <br />�o"rR. �a�E"Se# WASHIES$51 NS <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />REPLACE GAS WATER HEATER. <br />PLU <br />NO. � TYPE OF FtXTURE Ot2 ITEM <br />Tollet <br />Bathtub <br />Lavatory (wash basin) <br />Sh ower <br />Kitchen sink 8� disposal <br />Dishwasher <br />Ciothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc_) <br />Backfiow preventer <br />Urinal <br />Drinking Fountain <br />Ffoor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT' SOURCE <br />_ Electric � Gas _ Other <br />NO. <br />i <br />CONTRACT PRICE OF WORK <br />65Q� <br />MECHANtCAL <br />TYPE OF FIXTURE OR iTEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />I Water heater <br />�� Gas fireplace <br />', Gas range <br />I Clothes dryer <br />Range hood <br />Exhaus# fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE tS 3105 <br />i herehy ceritify that i have read and examined this applica6on and know ttie same to be true and correct. A8 provisions of laws and <br />ordinaces goveming this type of work wil! be cornplied 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 auihorized by the owner of this proper#y to perform the work for which application is made and ! comply with the <br />State Contractors Law 1£3 27 RCW and 296200 WAC. <br />�� �; 1I , Di�itallysigrxdbyJcunifnCovclla <br />� Y ; 1 �i{� -`-DN:cn�Jennrt..rCovello,00u,emeily.nniPer;m�^�penriiCcom,c-G; <br />c �.,� ; �F . . <br />' '-+�x n:ar.,.;nisii>airecna.nxnn� <br />Signature of Uv�� i�ii�unud�iur'lAuthorizeii Aaent natP <br />