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APPLI64TION FOR CONSTRuCTION <br />PERMIT <br />ME, Evergreen <br />ewLNMI <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />CI N I,.Q,,t •/) <br />QYVNER <br />MAIL ADDRESS G1; ZIP PHONE <br />John Hotchkiss 6714-H* End Or Everett 353-14117 <br />ZAP PHONE <br />TENANi <br />MAIL ADDRESS CITY <br />ARCHITECTORDESIGNER <br />MA11ADDRESS GTY ZIP PHONE <br />-_ <br />y <br />GENERAL CONTRACTOR <br />MAIL ADDRE55 CITY ZIP PHONE <br />LICENSE• <br />C H <br />Goode Canst <br />Inc 11217-60th St NE__1-k. SSeYeOs2�6---3=�t�-NTH' 1 0 <br />N <br />MECHANICAL CONTRACTOR <br />MAILADO RE55 G1Y ZIP PHONE <br />LICLUSE- <br />H <br />H <br />K' 0 <br />PLUMBINOLONIRACTOR <br />MAIL ADDRESS CITY ZIP PHONE <br />LICENSE• <br />innncinVFIFRDI INCFAT n RIIILOINORFLOCATION <br />TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />CONTRACT PRICE OF WORK 12,330.00 ,�'co�-/tea.. 1s-� <br />CONTACT PEfl50N ANO PHONE NO <br />Mark Goode 334-9262 <br />DESCRIBE WORK ANO SQUARE FOOTAGE INVOLVED <br />24 x 28 x 9 Garaae E�/2wi4ww sc. Ft— <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOWTHESAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIEDHEREINOR NOT. THE GRANTINGOFA PERMITDOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 'HE PER- <br />FORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND. <br />296.200 WAC <br />SIOHATUnEOFCO ACTOn DIi AUTHORIZEDAGENT DATE <br />AFPLICAHTS CITY BU5INLSS LICENSE NO AND BUSINESS NAME <br />LEGAL DESGRIPP Of PROPEAttiSNOWN BELONG ATTACH fOUR COPI£51 <br />LOT 10 BLOCK 4 OF North B�yeriv <br />Div. #2 Vol 10 plat page 46 <br />PROJECT ADDRESS <br />6714 Highland Or <br />PLUMBING none <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - A/HNDLG UNITS - H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS- BT.0 H1 EA <br />LAVATORY IWASH BASIN) <br />UNITHEATERS-B.T.U. hi <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK d DISP. <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />_ <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS - RAINLEAD ERS <br />EXHAUST FAN <br />SINK(SERVICF.- BAR. ETC.) <br />- <br />SUBTOTAL 5 <br />SUBTOTAL 5 <br />PERMIT S <br />PERMIT 5 <br />TOTAL FEE S <br />TOTAL FEE 5 <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBAC / <br />PIAN CHECK NUM BER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />�Z <br />LOTAREA <br />EAU ST SOEHO <br />FEES <br />VALUATION <br />FEE <br />BUILDING _-1 <br />Q11�_ <br />Ian <br />00 <br />TYPE OF CONST. <br />ALLOW LE/ACTUIIL <br />OCCUPANCY GROUP <br />NO OF OfYELlINO UNITS <br />PLUMBING <br />SIZE OF Bl:�O <br />Z0 <br />NO.OF STORIES <br />( <br />BSMT <br />❑Y <br />N <br />OCC LOAD <br />N� <br />MECHANICAL <br />OTHER <br />� <br />FIRE SPRINKLERS REQUIRED ❑YES 1fNQ <br />rtNT we�not+ <br />GT <br />t <br />STATE BUILDING SURCHARGE <br />SL% <br />APPLICATION ACC BY PLANS APPR BY <br />h2 <br />STATE ENERGY SURCHARGE <br />PUBLICWORKS <br />TOTAL <br />3 v <br />SC <br />