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I <br />the Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259•BB10 <br />,APPL16PION FOR CONSTRtAMON <br />PERMIT <br />TO BE COMPLETED IN INK — PLEASE PRINT <br />ARCHITECT OR DESIGN En MAILADDRESS CITY ZIP PHONE <br />Cl NEW h5 AUDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />everDlt <br />7'72O <br />TENANT IMPnOVEMCNT OR INTERIOR REMODEL ONLY <br />CONTRACT PRICE OF WORK <br />CONTACT PERSON AND PHONE NO <br />DESCRIBE WORK AND a UAAE FOOTAGE INVOLVED <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTIMG OFA PERMITOOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER- <br />FORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE OW NER 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 />206.200 WAC. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />LEGAL DESCRIPTION OF PROPERtt ISHOWN BELOW ORATTACM FOURCOPIEST <br />LOT eLocr. of <br />PROJEC ADDRESS �^ <br />�clt 7 v✓ <br />�LICANTS LCE�O. ANDNAME�j2��� <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 />(n <br />AfC—A(HNDLG UNITS—H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS— S.T.U. M EA <br />_ <br />LAVATORY (WASH BASIN) <br />_ <br />_ <br />' <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHESDRYERS <br />KITCHEN SINKS DISP. <br />VENTILATION FAN <br />DISHWASHER <br />rf Q <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />to <br />CLOTHES WASHER <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 />ROOF DRAINS — RAI NLEADERS <br />EXHAUST FAN <br />SINK(SERVICE —BAR ETC.) <br />SUBTOTAL <br />$ <br />SUBTOTAL S <br />iD <br />PERMIT <br />$ <br />PERMIT S <br />L 5 <br />00 <br />TOTAL FEE <br />S <br />TOTAL FEE S <br />56 <br />FRONT SETBACK <br />AFAR SETBACK <br />SIDE SETBACK. <br />PUN CHECK NUMBER <br />FEE <br />RECEIPTNO. <br />USEZONE <br />LOTAREA <br />VACANTSITE <br />DYES 0 NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPEOFCONST. <br />ALLOWABLE/ACTUAL <br />OCCUPANCYGROUP <br />NO. OF DWELLING UNITS <br />PLUMBING <br />30 <br />Do <br />SIZE OF BIDB <br />NO OF STORIES <br />BSMT. <br />OD N <br />Y <br />OLO LOAD <br />MECHANICAL <br />�� <br />S� <br />OTHER <br />FIRE SPRINKLERS REOUIRED DYES ONO <br />HEIGHTLIMITATION <br />I <br />STATE BUILDING SURCHARGE <br />APPLICATION ACC. OY PLANSAPPR BY <br />M m <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />5 It 150 <br />