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To: E Page 1 of 7 2015-12-18 06:38:46 (GMT) 18884000383 From: Deborah Shields <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-$810 — FAX 425-257-8857 — www.everettwa.org <br />51TE ADDRESS <br />152Q Gt�LBY AVE <br />LEGAL LOT NO. <br />DFSC. <br />)WNER <br />KATHRYN A REQUA <br />TENANT NAME <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />00553G3220270a <br />BLOCK I TRACT <br />`f 52� COLBY AVE <br />CONTACT FOR PERMIT <br />Naida Khan <br />CONTRACTOR 4��shinqton Energy Svcs Go, [_�,C ADQRESS <br />3909 196th St SW <br />CONTR. LICENSE # WASH ( E��S t N�? <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />REPLACE GAS WATER HEATER. <br />NO. <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory {wash basin) <br />5hower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/e[c.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEAT SOURCE <br />Electric � Gas _ Other <br />NO. <br />PERMIT # <br />�n 1 �, IZ-fC-�� <br />PHONE <br />�vFr�c� s��a� 425-418-5336 <br />PMONE <br />360-945-2757 <br />CITY/ZIP PHONE <br />Lynnwood 8�10-398-4663 <br />CONTRACT PRICE OF WQRK <br />9�a.�o <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />AtC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />�' Unit heater <br />' Boiler <br />Refrigeraiion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE I$ 31p5 <br />I hereby ceritify that I have read and exarnined this applic�lion and know the same to be true and correct. All pravisions o( laws and <br />ordinaces governing this type of work wiil be complied with whether specified herein or not. The c�rantiny of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or loc�l 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 ovith the <br />State Contractor�s Law 18.27 RCW and 296.200 WAC. <br />� � ��.. Digitally ci�nec: t�y.lenr.ifer C�v.r-liu <br />(.�;..1 � �.� ��-Df�:u- 1 n:iire� o�ello.� �u,email�jci-i`er';cnu;perniLc��ir,�._U� <br />5ignature of f orized Agerit c�,r�. ois.�� ����,�s:s, asc^Date <br />