Laserfiche WebLink
. ��^�. r`" I� s <br /> APPLIC.+CION FOR CONSTRI�.�TION � <br /> PERMIT <br /> � tho Evergreon evrre[t <br /> QTY OP � <br /> �verett • <br /> BUILDING DEPARTMENT <br /> 259•BBtO TO BE COMPLETED�N INK— PLEASE PRINT <br /> pWNER <br /> MPILADGRE55 LIIY 21P PIIONE <br /> � ��;� 7r ��m:n-I ��(a0 '���� �' /1'l�cert.`�slan���'o9�� <br /> ANT <br /> MAILAp� E55 CfY ZIP PHONE <br /> RNCHIIEGT OR OESIGNER <br /> MAILAOOFE55 � Ci1Y ZIP P�iONE <br /> IAAILAU�F[55 QtY ZIP PHONE LICENSE• , <br /> r� H GENEPAIGONiRACTOP - <br /> l•1�� <br /> tAAllA00RE55 GILY ZIP P��ONE L�CENSE• <br /> ME JANICALCONiRACi R a[!y SUP�LAC <br /> ��H �o I �iOy�l �('ero�eil-�n/ �/((C�.�l_4v��_9P1_(P--���5 ivr D� <br /> 9 H� P M�II ' ONj AGT R T MPILPOORE55 CIiY 21P PMONE LIGENSE• � <br /> � �USSOFWORK II <br /> y H <br /> h C) <br /> y� � NEW ❑ AODITION ❑ ALTEHATION ❑ RcPAIR ❑ DE1dOlITION ❑ WOOD5T0'E/FRPL INSERT BUIl01NG RELOC�TION �I <br /> L04LAGT PERSON AND PHONE NO <br /> � H� TENANTIMPROVEMENTOFINiERIONNEMO�ELONLY � <br /> yyr GONiPnCTPR:CEOGWORK <br /> � O� OESCNIpEWOPNANU50UAAEFOOTFGEINVOLVEO - / � ��(/ <br /> y� O � �(�i nFJ��gIL. ', /G//T lJ2l.l__ <br /> V�c�.� � <br /> paoC scDusEaFe�y+ IHEREBYCERTIFYTHATIHAVEREADNNDE%Ah11NEDTHISAPPLICATIONAND <br /> H �l7 ��� ��, I / ^,� ,n� KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSUFLFWSAN� <br /> � T[,la � ( �f'"K_ ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED W�TH <br /> �� n WHEiHERSPECIFIE�HEREINORNOT.THEGRANTINGOFhPERMITDOESNOT <br /> LEG LOESCPIViIONUFPROPEFlY15 WVOELOWORATIAOHFOURCOPIE51 <br /> .Z H� — PRESUME TO IiIVE AUTHORITV TO VIOLATE OF CANCEL THE PROVISIONS OF <br /> q �-]x �pt B�ocK aF ANYOTHeRSTATEORLOCALLAWREGULATINGCONSTFUCTiONORTHEPEF� <br /> t.� FORIdANCE OF CONSTRUCTION.THAT I Ald AUiHORIZED BY THE OW NER OF <br /> p.�y Thi15 PflUPERTY TO PERFORM THE WORN FOF W HICH APPUCATION IS MADE <br /> �y AND 1 COMPLY VJITH THE STATE CONTRACTORS LAW 1827 flCW AND <br /> Q y H 296200 WAC. <br /> Q C7 V� SIGNPIOREOFCOfRRACIOPOivA01110R12 AGENT OaTE <br /> � �� � . <br /> H O[n . D � � /�'�� <br /> PROJEGTAOOR[/5 PPPULA�U9iE55lILE��56 0<NDBUSINESSHPM1'E <br /> PLUMBING MECHANICAL <br /> FEE NO. N7EOFEOUIPMENT FEE <br /> NO. TYPE OF FIXTURE OH ITEM , <br /> j , WATERCLOSET(701LEp _ A/C—A/HNDLGUNITS—H.R �, <br /> FORCED AIR SYSTEMS—B.T.U. M EP <br /> ,'—_ BATHTUB <br /> LAVATORY�WASHBASIN) UNITHEATERS—B.T.U. M <br /> ! SHOWER CLOTHESDRYERS — �j <br /> KITGHEN SINK&DISP. I VENTILATION FAN _ <br /> �r DISHWASHER RANGE HOOD _ � <br /> !' LAUNDRYTRAY WNTERHEATER I <br /> CLOTHESWASHER _ �'�'OO�STOVE , <br /> METAL FIREPLACE 8 CHIMNEV . <br /> URINAL <br /> '�w FIREPLACEINSEAT — I <br /> A ' DRINKING FOUIJTAIN HEAT PUMP <br /> FLOOR DRAIN <br /> BACKFLOW PREVEN7ER5 GAS PIPI�G — <br /> ' FOOF DRAINS—RAINLEADERS EXHAUST FAN — <br /> SINK(SE(iVICE—BAF.ETC� �r�i�� <br /> „ ' _ <br /> R� 1 I <br /> SUB707AL 5 SUOTOTAI 5 — I <br /> PERAfIT 5 I <br /> �— PERMIT 5 i . <br /> TOTAL FEE S TOTAL FEE 5 <br /> FRONiSEiDAGK P[ARSEIBNGK SIOESETBACN <br /> PIANCHECNNUMOEN FEE PECEIPTNO. <br /> � - I <br /> � <br /> u5[zorvE LOTAREA vnCnt�lSrtE FEES VALUATION FEE j <br /> ❑VES ❑NO <br /> . BUILDING - , <br /> TYPLOFGONST. OCGl1PANCYGROUP NO.OFDWELLINGUNIiS ', <br /> ALLOWABLE/ACfORL PLUMBWG — ��. <br /> 5¢EOFBL�G. NO.Of510PIE5 BSYi� OCG.LGAD MECHANICAL �' <br /> ❑N I <br /> ��EicHiumiranon OTHER — <br /> FinEsrnrt+Kier+sneouineo ❑res ❑No STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCHARGE _ <br /> pPPLILAiIONACCBV PlANSAGPROY PUBLICK'ORKS <br /> Tora� <br />.��. . �Y l'" ' �7R��7'T�1�7R� �1�.i � S ,. r' b �S 4`d-'"r `s . '9'Si)y ¢� <br /> r K'h '`� r 4 �� ij.. � . n... � [ ".r. � � ,�.e � r ,Y�r n�r :� "3Y' yT :r? tt ti . �j Y"t�..i"���t'4�,��. <br /> I � .l N. <br /> � 1 a .':. S . S 3 ' { 5�.. �' �l '� A . t �¢�. <br />. IL . . �......��_.vu.�.u_vs—�i.�_�.r—..._ �..a.—. _.._�..—.�. _�._._.Ju.x.v_.i._� _ _. .�_�_ . .. .� . �i . ._..«_.._iJ �..�_...�..._�._ .il.u.�_ ..�. a�i:�_J:.�. <br />