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� � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32UU CEDAR 5TREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEP'TED FROM 8 AM TO 4 PM �-� g-b � <br /> SITE ADDRESS PARCEL TA%I.D.R PERMR* <br /> 5106 23RD AVE W 00669800001800 <br /> LECiA LOT N0. BLOCK 'lRACT <br /> DESC. <br /> OWNER ADDRESS GTl/ZfP <br /> CHARLES GUILNDER 5106 23RD AVE W, Everett 98203 425-355-9066 <br /> TENANT N�11E I CONTACT FOR PERMR PMONE <br /> MeliSSO Grotlz/Northwest PeRnit Inc 380••945-2787 <br /> co►rrw�croa WESCO u�oaEss cmrmr VIIONE <br /> corme.uc�ses WASHIES971 OB 2800 Thorndyke Ave W seeme� se�ss 206-378-6649 <br /> USE OF BUII.DING HEAT SOURCE CONTRAC7 PRICE OF WORK <br /> Residential I _e�a�;� x �� � I $950.00 <br /> WORK DESCRIpTION <br /> Replace a gas to gas 50 gallon water heater <br /> PLUMBING MECHANICAL <br /> NC). TYPE OF FIXTURE OR ITEM NO. TVPE OF FlXTURE OR 1 TF]q <br /> Toiiet A!C—alr handl'mg unils <br /> � Bathtub Foradairsygtems <br /> _ Levatory(wash beein) Gae p�p�ng <br /> � Shower � Water heater <br /> Kitchen sink&disposal ^ Gas fireplaoe <br /> piyhweaher Gas range <br /> Clotheswasher � Ciolhesdryer <br /> _ Laundry Vay Renge hood <br /> Sink(serv'w�afi?rlmn�latr.) � F.xhaust tan <br /> � 8adcflaw preventer Heat pump , <br /> Urina� _ Unil heater <br /> Drinkinp Founlain ` 8oiler <br /> — Floor drein Refrfperafion <br /> Grease trap ` Woodstove <br /> Roof drains ` Other <br /> — an� <br /> — � <br /> Ct7Y OF EVERETT LOCAL SALES T�7C CODE�4 71D6 <br /> 1 hereby crriNty Mat 1 have reatl and ezemined this application and know ihe same lo be true and cortcd Ail provlsions of lawe and <br /> ordineces govemtng this type of work will be comp:ied wNh wh¢ther epecified herein or noL The prenGrg of a pxmit does not presume <br /> to give authority to violate or cancel the provlslon of any other state or local lew regulating conshudion a;he perfortnance o( <br /> conshudion.That I am auHiorized bv the owner of this property M perfortn the xork for whieh appficetion�s ma"e and I mmply wilh the <br /> Stete Contrad yLaw 18.27 R and 298.200 WAC. <br /> rg�i1,�'���� �1�� <br /> �riature of ier o� gen --��• <br />