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DocuSign Envelope ID:585D5F83-9B49-4DA4-BCED-09EFDA53EF05 <br /> YUCit/ COMMERCIAL NATURAL GAS Service Contract is <br /> PSE SOUND SERVICE FACILITY SERVICE CONTRACT days eafter revision7g90 <br /> ENERGYN <br /> Customer(Owner)Name Co-Owner Name(if applicable) <br /> Everett Fire Dept. <br /> Service Address City Zip Code <br /> 2290 16th St Everett 98201 <br /> Mailing Address(if different from above) City State Zip Code <br /> 2930 Wetmore Ave Everett WA 98201 <br /> Primary Phone Alternate Phone Email Address <br /> 425-328-4659 <br /> Type of Service Required <br /> ® Existing ® New Construction <br /> Your Natural Gas Usage Plans Additional Job Details <br /> IF YOU CHANGE YOUR APPLIANCE SELECTION,PLEASE NOTIFY YOUR PSE REPRESENTATIVE <br /> Gas Usage BTU/HR ANNUAL THERMS <br /> O Space Heating 7nnlc <br /> X❑ Water Heating 400K <br /> O Cooking 80K <br /> ❑ Process <br /> X❑ BBQ 60K <br /> El <br /> Total: 7An1( <br /> Building Square Footage: <br /> Desired Delivery Pressure at Meter oX 6"W.C. ® _psi <br /> Payment Information <br /> Customer Payment: Pay$0.00 prior to scheduling installation of facility. <br /> Security Deposit: <br /> APPROVED AS TO FORM TOTAL CHARGES $0.00 <br /> e...: /SA•dfo'15"T_._Le/LfiOLarr-- <br /> Customer Acceptance C..y �•> , <br /> By signing this Service Contract you are authorizing PSE to continue with all the needed elements to complete your project.Upon receipt of a signed Service <br /> Contract,PSE will bill you for the amount indicated at the mailing address shown on the Service Contract.Please follow payment instructions on that billing <br /> statement.PSE requires payment prior to firming up a construction date;delaying payment may result in a construction delay.Changes in the scope of the <br /> project requested by you may result in either additional charges or refunds to the amount billed on this Service Contract. <br /> It is agreed and declared that the terms of conditions set forth herein and on the reverse hereof are part of this Service Contract and binding upon the <br /> parties hereto.Customer grants permission for PSE to access credit information when necessary.This Service Contract is not valid until accepted by PSE. <br /> Customer acknowledges the receipt of a copy of the Service Contract. <br /> Important Note: <br /> In addition to the charges above,you will receive a bill from PSE for monthly basic charges as soon as the meter is installed. <br /> c .1 .1a <br /> otc- ev.fetit- <br /> custom-rSignature Print Name Cassie Franklin/ M. Date /1• <br /> Z%,/ Oi / <br /> ATA T: <br /> AL/ IA - • Notification Number 507925469 <br /> City Clerk <br />