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� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CED/�R STREET, CVERETT, WA 96201 <br /> 425-257-6610—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIaNS ARE ACCEPTED FROM 8 AM TO 4 PM (� _ �C.( �� � <br /> SITE ADDRESS pARCEL TAX I.D.# PERMfT il <br /> 4701 GARDNER AVE 00417400003000 ►'�'� �pG(� -p/7 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CI7V21P PHONE <br /> IGNATIUS MARSlDI 4701 GnRDNER AVE Eve�el198203 425 347-1521 <br /> I TENANTNAME CONTAC7FORPERMI7 pHONE <br /> INaida Khan 360-945-2787 <br /> CONTRACTOR WESCO aooRess cirraiv PHONE <br /> CONTR.LICENSEiI 2800 Thorndyke SEATTLE 800-398-46s3 <br /> WASHIES971 OB <br /> uSE oF BUILOING HEAT SOURCE CONTRACT PR�CE OF WORK <br /> SFR _e�eccnc ��as_otner I $g50.00 <br /> WORK DESCRIPTION <br /> REPLACE 50 GALLON GAS WATER HEATER <br /> PLUMBING M HANICAL <br /> NO. TYPE OF FIXTURE OR I7EM NO. TYPE Of FIXTURE OR RGM <br /> i onet EVC—alr handiing uNts <br /> _ Bathtub _ Forced air systems <br /> _ Lavatory{wash basin) Gas piping <br /> _, 3howe� + Waterheater <br /> Kitchen sink 8 disposal Gas fireplace <br /> _ Dishwasher � Gas range <br /> _ Clolheswasher Cbthesdryef <br /> _ Laundrytray � Rangehood <br /> _ Sink(serviceroarlmopletc.) Exhaust fan <br /> _ Backitow provanter � ryeat pump <br /> _ Urinal Unit heater <br /> _ Drinking Fountain � 8oiler <br /> _ flao�dtain _ Rc(rigcmt�on <br /> _ Greasa trap Woodstove <br /> _, Roof drains _ Other <br /> � O�her . __ <br /> cITT OF EVERE77 LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritiry that I have read and examinad this appliention and know the same to be true and rnrrect. Ail provisions of laws and <br /> ordinacee gnvaminp this typ+e of work will ba eompliad�Hlh whcthcr apecificd hercln or not.The granGny uf a pertnit dves naI pr25ume <br /> to give authonty ta violote ar cancel the provision of any other state or loral law regulating wnstruction or the pedormance of <br /> construction.That I am authorized by the owner of this propeny to pertorm the work for which application is made end I comply with the <br /> , Stafe Contractors Law 1 B. % W and 79R 9nn wnC. <br /> �.. Ce ll <br /> Signawre o O�ner nu clor/Authoraetl Aqent �a e <br /> � <br />