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To: E Page 2 of 8 2016-01-19 2'1:59:52 (GMT) 18884000383 From: Deborah Shields <br />SITE ADDRESS <br />3�07 OAKES AVE <br />LEGAL LOT NO. <br />DESC. <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 />PARCEL TAX I.D. # <br />0043g185600300 <br />BLOCK I TRACT <br />M IT # <br />IIQ� I�o�2 <br />vwrvtrc AUUKt55 GITY/ZIP PHONE <br />NADRA HG}PKINS 3507 OAKES I�VE Everett 98201 425-3�5-9747 <br />TENANT NAME CONTACT FdR PERMIT PHONE <br />Naida Khan 3�0-94��2�787 <br />CONTRACTOR V,Ja�flll'lgtOfl �f1Gi"yy SVCS C;O, I_LC '4DDRESS CITY/ZIP PHONE <br />3909 196th St SW Lynnwood 8Qa-398-4�63 <br />CONTR. LICENSE# l�)A�H�E�U�� iVS <br />VV <br />USE OF BUILDING <br />SFR <br />WORK DESCRIPTION <br />REPLAGE GA5 WATER HEATER <br />NO. <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory {wash hasin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Cloihes 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 />Olher <br />HEAT SOURCE <br />Electric � Gas _ Other <br />NO <br />� <br />CONTRACT PRICE OF WORK <br />�' � i� <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />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 />He�t pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CdDE IS 3105 <br />I hereby ceritify th�t I have read and examined this application and knaw the same to be true and correct. All provisions of laws and <br />ordinaces yoverniny this type of work will be cornplied with whether specified herein or not. Tl�e granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or loc�l law regul�ting construction or the performance of <br />construction. That I am author-i�ed by the owner of this propeRy to perform the work for which application is made and I comply with the <br />State Conl ^ � ' � � `t� ��'� � p <br />'� and 29�. <br />,.w S�, � . ����t�'sl�� �c' byJciinTcr�nvt� In <br />� ": ,7 � � .y! � � '� . aN m—Jc �ndcr ov,^Ilv, o, ou, <br />'�, � -r � d'� ��s�` > > tar_ nv,r , ei �nd.cor^, a=US <br />�"' ���11 Ji,�L�l� Je� � en�ail��o, , n, <br />. �� �. ,,, ; <.+� �, , <br />gnature ��;���:::.,,.,��;''�.,, ��,..,;�„�„ ;�ihoriz�� A f t" ." ' ' Date �� <br />�����1-_ <br />