4809 EVERGREEN WAY 2016-01-01 MF Import

�� AF'1'LI�iEI►7IV t�JK {rV1�1, 1 KYV 1 I '1�1 NCKMIT /^/� � TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��_. BUILDWG DEPARTMENT M HEATING SYSTEM: � AS ❑ELECTRIC ❑ 259•8810 `nC7{�I/7 �2-�""��0� �� U�C.� ��U Li.�p� . ❑ DEMOLITlON ❑ COMBINATION ❑ BUILDING 'kHf€CHANICAL ❑ PLUMBING ❑ SIGN OWNER lAAILADDRESS CITY ZIP PHONE T�2lr�.�l lCS ING t3��1-uUE w!� �l'`6Gb�S �ZoG) $5� -�l-o�l TENANT MAIL ADDFE55 CITY 21P PHONE U�czc . APCHITECT OF DESIGNER MAIL ADORE55 CITV ZIP PHONE '�tPI1A+.�ON�t cS� L nS G GENERAL CGNTflACTOR MAIL ADOFE55 CITY ZIP PHONE STATE LICENSE R MECHANICAL CONTRALTOR R1AIL AODFE55 CfiV ZIP PMOfJ��^(,'`'� TATE LICENSE a �'�MbJo C.�,�30►-� HT6 �14 5..� C{�Mf4n`A C2 CAMA�*�lo . `Jl V�21 �f CXo6cM PWMBING CONTflALTOF MAIL AODRE55 LI7V ZIP PHONE STATE IICENSE t CUNTRACT PRICE OF WORK /�� 7g"". � �� DESCRIBE YIORK AND SOUARE FOOIAGE INVOLVED CONTACT PERSON AND PHONE NO. � � ��R�r �A��S NO Q.L�wa�� N[REdY CERTIFY THAT I HAVc READ AND EXAMINED THIS PROPOSEOUSEOFOUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRtCT.ALL U1-� 1J PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF LEGAL�ESCRIRTIONOFPROPEfliY(SMOWNBELOWOqATiACHTN/JGOPIES) WORK WILL BE COMPLETE�WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE �oi 6iOCK — OF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOIJS OF ANY OTFiER STATE OR LOCAL LAW REGULATING CONS7RUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE O NER OF THIS PROPERTY TO PERFORM THE '.VORK FOR WHICH A PLICATION IS MADE AND I COMPLY WITH THE STATE PRRC'cL TAX I.D.NOMBER C NTRACTOR W 18.27 RCW AND 296200 WAC. CON°NTRUCTQION LOF.'1 LEN�JER.�AODRE!S-S.IELEPHONE NUNBEB � �ll(/ "^t30.� � �t/CK-�� PAGJEf:TADDR._nES�` ' `' sicnnruac — or,, F11P��c..cin w.�- ao3 ��..a�=��Es=�,��=E�o F'LUMBINTa � MECHANICAL Np. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE WATER CLOSET(TOILET) � NC—�'JHNDLG UNIT�--H.P. � � BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � SHOWER ' CLOTHESDRYERS ' KITCHE�SINK 8 DISP � VENTILATION FAN � DISHWASHER � RANGE HOOD � LAUNDRYTRAY � WATERHEATER ' CLOTHES WASHER � WOOD STOVE � URINAL ' METAL FIREPLACE(WOOD BURNING) ' DRINKING FOUNTAIN i FIREPLACE INSERT � FLOOR DRAIN � HEAT PUMP � BACKFLOW PREVENTERS ; GAS PIPING � ROOF DRAINS—RAINLEADERS � EXHAUST FAN � SINK.(SERVICE—BAR,ETC.) ; � i � � � � � -- —T— , � SUB T6iAL $ ; SUB TOTAL $ ' PERMIT $ � PERMIT $ � TOTALFEE S TOTALFEE $ ' FOR OFFICE 11SE ONLY: fPONTSETBACK REARSETOACK SI�cSETBACK PLANCHECKNUMBEP FEE FECE'PTNO. y �� JSE ZONE LOT aREA VACANT SITE FEES VALUATION FEE ❑ YES ❑ NO ,gUILDING � 7VCEOFLONST. NO.OFSTOfliES o[NVANtY xaurm'rtLUHGUNns i taouv PLUMBING i SIZcOFBLDG. FIRESPRINNLEFSREO'D BASEMENT MECHANICAL � ❑ YES ❑ NO — � ADDI710NAi PLAN CHECK � OCCUPANCYLOAD FIREALAPMREO'O HEIGHTLIMITAiION � i OTHEFi ' i REASON �— ' STATE BUILDING SURCHARGE i i INTFKEBY PLANSAPP EDB}� � CITYOFEVEREIT PUBLICWORNS j � ��i� LOCAL SALES T— oAre _ �_y TAX CODE IS 3105 TOTAL ;