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SITE ADDRESS <br />4510 GRAND AVE <br />LECAL LOT NO. <br />DESC <br />JASONLOYA <br />TENANT NAME <br />CONTRACTOR\A/ESCO <br />�� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM I._ <br />BLOCK <br />CONTR. LICENSE N, p,AS H I ES97 � O B <br />VY <br />USE OF BUILDING <br />Residential <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />00605502300202 <br />TRACT <br />4510 GRAND AVE <br />CONTACT FOR PERMIT <br />Jennifer Burgess <br />AD�RESS <br />3909 196 St SW, <br />HEAT SOURCE <br />� Electric _ Gas_ Other <br /># <br />1— <br />Everet198203 425-512-9212 <br />PHONE <br />206-774-9499 <br />pN/ZIP PHONE <br />Lynnwood 98036 $00-398-4663 <br />CONTRACT PRic=t c�r �rvvnn <br />$4596.60 <br />- �A�'ER-W►TFi�D`pF-GkgPIPtRiG <br />S,�l,'.� �-i-e�.t-,� �-i� S � S f�..-, <br />PLUMBING , MECHANICAL <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Hatntub <br />Lavatory (wash basin) <br />Shower <br />kitchen sink & disposal <br />Dishwashet <br />Clothes washer <br />Laundry tray <br />Sink (servicelbadmop/etc.) <br />BachBow preventer <br />Urinal <br />Dnnkmg Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher __ <br />NO. � TYPE OF FIxTURE OR ITEM <br />NC — air hanaling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas iireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Ezhausttan <br />Heat pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Wootlstrne <br />Other <br />� <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby ceritity that I have read and examined this application and know the same to be true and correct. All prwisions of laws and <br />ordmaces governing thistype of work will Ue complied wlth whether specrfied herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel lhe provision of any other state or local law reoulating construction or the pedormance of <br />construction That I am authorixed by the o�mer of Ihis property to oertorm the work for whkh application is made and I comply with the <br />State Contractors Law 1827 RCW antl 296200 WAC. <br />Ci.1P,dly J.lnnt W �mrlin ow9e�� <br />Jennifer Buraess ;�;����_m°:,��:a����: m����.m����;���.��_�...,,,,.,_� <br />