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To: E Page 2 of 7 2015-10-01 21:23:53(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.# PERMIT# <br /> 1430 W Casino Rd #81 I 00865700808100 IIV1 1610-013 <br /> LEGALI LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> Frances Perkins 1430 W Casino Rd #81 Everett 425-314-3085 <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 /> p 3909 196th St SW Lynnwood 800-398-4663 <br /> CONTR.LICENSE#WASH I ES851 N S <br /> USE OF BUILDING 1� HEAT SOURCE CONTRACT PRICE OF WORK <br /> CONDO-SINGLE FAM _Electric 1,Gas,.__Other 1251.27 <br /> WORK DESCRIPTION <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) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> — <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 Boiler <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 Co 4' F ,,E`1to 0r I,nd 296:20giWA ned by Jennifer Covello <br /> �tiV� 4 `, iZ h DN:cn=Jennifer Covello,o,ou, <br /> orf '+'zn)ail-jennifer@nwpermitcom,c=US <br /> Signatur=, j`; `' °i 4 "orized Ag�Y 2015.10.01 14.16.53 oroa Date <br />