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SITE ADORESS <br />a - <br />LE6A LOT NO. <br />DESC. �3 .� � <br />OWNER <br />� �-m�►i <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />� <br />a <br />PARCEL TAX I.D. ♦ <br />CONfACTNAME <br />IQ <br />PMONE <br />- Od-3 <br />5c�me, i �m� <br />corrrn�cr� eoll�� � /'I/ �23 g/lb�.�. NE a" corrrn. ucera� � <br />Ibr� 982�z R-�BRI�.o'I�KP <br />���n) (e9/-�398 Gran.ite�Is, w{� <br />PROPOSED USE OF BUILDINO <br />� <br />Building <br />PERMI7 Combination <br />TYPE Demolilion <br />Sprinkler <br />COHTRACT PRICE OF WORK � R�nn �� <br />Mechankal <br />Plumbing <br />Sign <br />�pdditbn I T SOURCE <br />Iteratlon R EleMriC <br />ew N ��..j Oee <br />D RepeidMsinl. U Other <br />CITV OF EVERETT LOCAL SALES TAX CODE IS J10S <br />WORK DESCRIPTION ' <br />Cons�r��+ ne.u� d�.�a�ln.e�. g�a��- <br />NO. I TMPE OF FI%TURE OR REM <br />WATER CLOSET <br />BATHTUB <br />IAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINK�NG FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BARlMOP/ETC.) <br />OTHER <br />NO. I TYPE OF FlXTURB OR ITEM <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS ., <br />HEAT PUMP . <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />OAS FIREPLACE <br />OAS RANOE <br />GAS PIPINO <br />EXHAUST FAN <br />OTHER <br />1 HEREBY CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE T. RUE AND CORRECT. ALL <br />PROVISIONS UF IAWS A�ID ORIOIhACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WNEfFiEP. SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY T�O PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC70FiS LAW 18.27 RCN( AND 296.200 WAC. <br />�Z <br />