Laserfiche WebLink
MIT Evorproon <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259.8810 <br />i <br />APPLICATION FOR (CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK — PLEASE PRINT <br />CYNIER MAILADDRESS OlY 71V <br />ie <br />Vvzis Cn 132nd Ave <br />SE Suite <br />3Q0__ Bellevue, <br />39A 98006 <br />1.-800-922-9311 <br />TENANT <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />To be determined <br />AnC111 i ECT OR DE51ONER <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />Dykeman Architects <br />1602 Hewitt <br />Ave. Suite 400, <br />Everett, <br />WA 98201 259-3161 <br />GENERAL CON I RACTOR <br />MAILAOOnESS <br />CITY <br />ZIP <br />PIIONE LICENSE • <br />To be determined <br />IAECl/ANICALCONTRACIDR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />To be determined <br />PLUM TING CON I MCI On <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />To be determined <br />CLASS OF WOnK <br />❑ NEW ❑ ADDITION 61 ALTERATION ❑ REPAIR <br />❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT <br />❑ BUILDINORELOCATION <br />TENANI IMPROVEMENI OR INTERIOR REMODEL ONLY <br />Estimated . �12,000 <br />PANITACT PRICE OF Won <br />CONTACT PERSON MID PHONE NO <br />Cai hompso^n or Ty Heim <br />DESC1RuET} ORRNDSOUS FOOTAGore [INVpOLVD �T]F <br />,ri� I Abu ri-Tn-�LS� 'Sil <br />$jnC811 Il� <br />, e <br />PROPOSED USE OF BUILDING <br />Retail sales Or service <br />I HEREBY CERTIFY III TAT I HAVE READ AND EXAMINED 11115 APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BECOMPLETEDWITH <br />WHETHER SPECIFIED HEREIN OR NOLTHEGRANTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANYOTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER. <br />FORMANCE OF CONSTRUCTION. THAT I 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 1827 RCW AND <br />296.2DO WAG <br />SIGNATBHE FCONIMCTon On AUTNORIZED AGERT DATE <br />X a. cep (_�7 -Rw10 3p_-- <br />�� <br />LEGAL DESCnIMIONOFPnOPERTYISIWWNBELOWOHATTACHFOURCOMES( <br />LOT BLOCK- Dr <br />Attached <br />- <br />— <br />PROJFATAODRESS <br />7601 Evergreen Way Suite C-1 <br />APPLI ANB GT B15WEL4 UC ENO. AND BUSINE33 NA5 <br />0 01157 T11e keman Architects <br />PLUMBING <br />MECIIAN A <br />NO <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. P OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C-A/H D UNITS -H.P. <br />_ <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. MEA <br />LAVATORY (WASH LASIN) <br />UNIT HEATERS -BTU. M <br />_ <br />_ <br />SHOWER <br />CLOTHES DRYERS <br />_ <br />KITCHEN SINK& DISP. <br />VENTILATION FAN <br />DISHWASHER <br />RANGEHOOD <br />_ <br />_ <br />LAUNDRYTRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />_ <br />MEAL FIREPLACE& CHIMNEY <br />_ <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />_ <br />FLOOR DRAIN <br />HEAT PUMP <br />_ <br />_ <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS - RAINLEADERS <br />EXHAUSTFAN <br />SINK(SERVICE- BAH. ETC) <br />SUBTOTAL <br />S <br />SUBTOTAL S <br />_ <br />PERMIT <br />S <br />PERMIT S <br />_ <br />TOTAL FEE <br />S <br />TOTAL FEE $ <br />FRONT 5ETGACK <br />REARSETBACK <br />SIDESETBACK <br />PLANNCFHEEC NUMnBE1 Fyy <br />sEJ7 CR O <br />FEE �L <br />OEJ <br />RECEIPT nD, <br />USEZONE <br />TYPE <br />LOTAREA <br />VACMI SIT_4 <br />D YE5 Oloom <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />) <br />12 <br />OF CONST <br />w 1 <br />aLowAGLEJAciuAL I� <br />OCCUPANCYOROUP <br />¢) '. vL <br />i <br />NOOFDWELUNGUNIT5 <br />.Q—.. <br />PLUMBING <br />SIZE OF BLDG. <br />(, 1 <br />NO.OFST✓ORIEB <br />1135MT. <br />lay <br />OCC LOAD <br />i1_ <br />MECHANICAL <br />OTHER ' �� <br />i$ <br />/0_ <br />FIRE SPRINKLERS REouinED VE5 ONO <br />HEIG14TLIMITTAIIN <br />1V, <br />STATE BUILDING SURCHARGE <br />APPUCADON ACC BY PLANS APPR BY <br />IYIjL'/�' /p•,4{e�I <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />