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To: E Page 6 of 7 2016-01-04 15:46:47(GMT) 18884000383 From: Deborah Shields <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.# PERMITs-- <br /> # �D� <br /> A \ <br /> 2901 EVERETT AVE 29052000408200 ' <br /> LEGAL}, LOT NO. BLOCK TRACT f V ` <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> HENRY M GILMORE 2901 EVERETT AVE Everett 206-499-5957 <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#WAS H I ES851 N S <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> SFR _Electric VrGas_Other 6800.00 <br /> WORKDESCRIPTION <br /> REPLACE GAS WATER HEATER. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet NC—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) GasPeI i <br /> ng <br /> Shower 1 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/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boller <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 /> I 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 /> ordinaces 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 Contra .,s.La'7.$,. ,, W and 296.200 WAC. <br /> t e3ti �+°iF {R;''��.::. , Digitally signal by J_nni*nr Co+cIto <br /> x'� dJ a�°�It <br /> y y +zx,y t= sq. r'.l?Nrn—c�+nlfrr Cowl k),�'+,ou cmzll—jrnnifer_�nsJpCrmit.eorl.4,4-IS <br /> c..�,_x,...i.+.,,_..;,;.:y„s:5:d�"°� ." Cine:2i�t6.01.F4 C%.3725-7l3tXi <br /> Signature of d wneriContraato',ut orized Agent Date <br />