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To: E Page 4 of 6 2015-09-29 17:19:36 (GMT) 18884000383 From: Deborah Shields <br /> 0 0 <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 /> 1315 GRAND AVE 00438524300700 <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> JUDY ACCIAI 1315 GRAND AVE Everett 425-259-3647 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> Maida Khan 360-945-2787 <br /> CONTRACTOR Washington Energy SVGS 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 V/—Gas_Other 4602.20 <br /> WORK DESCRIPTION <br /> INSTALL GAS FIREPLACE <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C–air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal i Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(serviceibar/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 /> 1 hereby ceritify that I have read and examined this application and know the sarne 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 Contractors l.aw 18.27 RCW and 296.200 WAC. <br /> 1)Y � Dlgitilly signed by Jennifer Covello <br /> ,w,yk� �r3� .UN:ero-Jennifer Covello,o,ou,email-=ennire,pnwpenni[.com,<-VS <br /> �'�A� -� '�• - Deie:2U1;,09.2910 U2:>9-0?b0' <br /> Signature o 'Owner/Gontrad or/Authorized Agent Date <br />