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u <br />i/ <br />m <br />APPLICm4TION FOR CONSTRUCTION <br />PERMIT <br />the Evergreen I <br />rvrn•II <br />CITY OF <br />everett 0 <br />BUILDING DEPARTMENT <br />259-8810 TO BE COMPLETED IN INK - PLEASE PRINT <br />P <br />—__.__ uui mnoccG CITY LIP PNOtIE <br />MECHANICAL CONTNADTDR MAILADDREW GTY ZIP PHONE LICENSE• <br />PP�� Lp <br />iOI...V1 - I_T �, n.. "Tn r.,.•.... IPa_ Fl.le• 9��-Y10 •2N7-A21.n <br />PIRIIIE CE 9EF <br />1­9 F9 e In neurN I.mm ❑ WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br />IL! NCYY t nVVIIIVn <br />TENMJT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />_ <br />CONTACT PERSON AND PHONE NO. <br />OD <br />F 45 oo <br />CONTRACTPAIOEOFYARK <br />DESCRIBE WORK AND HOUARE FOOAOEI VOWED <br />PROPOSED UHE OF BUILDING <br />I HEREBYE I HAVE READ AND EXAMINED THIS APPLICATION AND <br />L�� 1(�l <br />KNOW THESAMETO BETRUEAND CORRECT. ALL PROVISIONS OF LAWS AND <br />SAME TO SE <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOTTHEGRANTINGOFA PERMIT DOES NOT <br />LEGAL DESC PTIM ONOF GPOPERTYI Hf0 NBELOW OR ATTACH FOUR COPIES) <br />Jr ` O <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />STATEOR LOCAL LAW REGULATING CONSTRUCTION OR THE PER- <br />LOT ,!g BLOCK OF _13 <br />ANYOTHER <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />2 n, <br />THIS APPLICATION ADE <br />THEWORKCON <br />zIwuj�� �y <br />A---17/rt2�G[ <br />RACTOOR <br />RCW ND <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />I COMPLY THE S <br />298.200 WAC <br />llt <br />HIGNANREOFCOWRACTOROR2UTHOOAtlE/DAOyE�NT DATE <br />wy{� <br />J <br />X/ <br />4^'ii`/r17�Cr—don L <br />/�"w .O_Am <br />PROJECTADDRESS <br />l <br />AP ANAND BUSINESS NAME <br />PLUMBING <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- BTU. M EA <br />LAVATORY (WASH BASIN <br />ld <br />UNITHEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK& DISP. <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHESWASHER <br />WOOD STOVE _ <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSErT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />_ <br />ROOF DRAINS - PAINLEADERS <br />EXHAUST FAN <br />SINKISERVICE- PAR ETC) <br />SUBTOTAL <br />& <br />SUBTOTAL S <br />PERMIT <br />& <br />PERMIT $ <br />TOTAL FEE <br />S <br />TOTAL FEE & <br />FRONTSETBAC <br />REARSETBM:K <br />SIDESETBACK <br />PLANC <br />ECK NUMBER <br />I[[ <br />R[PT MO. <br />.10 <br />U✓ <br />USEZONE <br />Lm AREA <br />ESTSITE <br />No <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />- ( <br />�• <br />7 <br />O <br />TYPE OF fA)NHT. —. 1 <br />OCWPANCY GROUP <br />NO.OF DWELLING UNITS <br />ALLOWABLF/ACfU <br />PLUMBING <br />SIZE OF BLDD. <br />NO OF STORIES <br />BSMT. <br />OCC LOAD <br />MECHANICAL <br />OTHER <br />Y <br />MEIONT LIMISAT;N <br />STATE BIJILDING SURCHARGE <br />L <br />t <br />FIRE SPRINKLERS REWIRED OYES AD <br />�`� <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />APPLICATION ACC BY PLANSAPPR.BY <br />TOTAL <br />y� <br />