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P�..RMIT APPI_ICATII,N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.• PERMIT M <br /> 1602 EAST MARINE VIEW DR. 5563-324- C �� <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. 1,2,3,4 324 RIVERDALE ADDITION TO EVERETT <br /> OWNER ADDRESS ZIP PMONE <br /> GEORGE T. KAISER FAMILY TRUST 11014-19th AVE S.E PMB 330 EVERETT WA. 98208 <br /> TENANT NAME CONTACT NAME�p�,Q� G.(LU.� PHONE t�j.5 330�'� 7 <br /> i^— _� <br /> GRANSTROM'S TROPHIES K.C. GRANSTROM 425-252-4141 FAX 425 252 1;�85 <br /> CONTHACTOR ADDRESS ZIP CONTR.LICENSE M <br /> PHONE <br /> PROPOSED USE OF BUILUING Building I") Mechanical Addilion MEAT SOURCE <br /> PERMIT � Combinalion H Plumbing WOHK B Alleralion [� Electric <br /> TYPE Demolition �� Sign 7YPE D New � Gas <br /> Sprinkler U Repair/Maint. O�her <br /> CONTRACT PHICE OF WORK — — CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> WORK DESCRIPTION <br /> C/� /�� !IT �� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM NO. TYPE OF fl%TURE OR REM <br /> WATER CLOSET AIC—A/HANDLING UNITS <br /> � _ BATHTUB _ FORCED A�R SYSTEMS <br /> I _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> OISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> ; _ FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICElBAR/MOPlETC.) _ EXHAUST FAN <br /> OTHER OTHER _ <br /> � _ — <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL <br /> ' PROVISIONS OF L4\VS AND ORIDINACES GOVERN�NG THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ' NOT, THE GRANTING OF A PERMIT DOES NOT PRESUAIE TO GIVE AUTHORITY TO V�OLATE OR CANCEL THE PFOVISION OF ANY OTHER <br /> � STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOtiA7ANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORhI THE WORK FOR WHICH APPLICATIOM IS h1ADE AND I COMPLY WITH THE STATE <br /> I CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> i <br /> Signature ol OwneuConiractodAuthorized Agen� Date <br /> , �la <br />