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6 <br />� ' r . . (r... r, ;', <br />APPLI��iTION FOR COIMSTR�CTIAN <br />PERMIT <br />the Evergreen <br />CITY OF <br />evPrett <br />B ILDING DEPARTN�ENT <br />everelt <br />� <br />U <br />259•88to TO BE COMPLETED IN INK— PLEASE PRINT -�� ��'o <br />OWNEfl �r/ILAOURESS GITY ZIP PIIOIIE <br />Vyzis Company 132nd Ave SE Suite 300 Bellevue 98006 1-800-922-9311 <br />TENPNT MAILA�DHE55 CILY ZIP PMOIlE <br />Cascade RTO Company 3017 139t1i P1 SE Botliell 98012 337-8570 _ <br />AflCN1TECTON0E514NEN MRILPDOfiESS CItY iIP PMONE <br />D keman Arcliitect� 1602 Ilewit� Ave. N400 Everett 98201 259-31G1 <br />OENERALCONTRACTOR MAI�AD�AESS LItY ZIP PHONE LICENSE• <br />To be determined <br />MECH�NICPLCONTMCTOH M�ILAO�RE55 CITV 21P PHONE LICENSE• <br />To Ue determined <br />PLUM'JINCGONTNAGTOR MRIL��OflE55 GITY ZIP PMONE UCENSE• <br />To be determined <br />G1A59 OF VIORK <br />❑ NEW ❑ ADOITIOIJ � ALiERAiION ❑ FEPAIR ❑ DEMOLITION ❑ VdOOD570VE/FRPL INSERf ❑ BUILDING RELOCA710N <br />'LOT <br />i � <br />i <br />J <br />�., w��,..., <br />OF WORM <br />\ND 50 WAE FOOTAGE I <br />t, dqqr$ , & <br />��h�' <br />v euaoiNa <br />)a S TV� C <br />]N UF PROPEBtt �SMOY <br />BLOCN OF <br />7601 Evergreen {4ay Suite B-1 <br />PLUMBINO <br />JO. TYPE OF FI%' <br />\VATER CLOSET (TOILE <br />OATHTUB <br />:AVATORY(NASH BASI <br />SHOWER <br />KITCHEN SINKB [lISP. <br />DISHWASHER _ <br />LAUNDRY TfiAY <br />CLOTHES WASH[F <br />URINAL <br />�RINKING FOUNTAIN <br />POOF <br />�� <br />FIqE SPpINKLER9 <br />— RAI <br />— RA <br />SUBTOTAL 3 <br />PERIAIT S <br />TOTAL FEE S <br />ISETBFCK SIOESET[ <br />� <br />\qEA VACANtS <br />❑ YES � <br />JPANCYOROUP NO OF DV <br />'� � <br />)FSI0PIE5 BSMT. OCGLORI <br />❑Y '] / <br />❑ N �7l G <br />HEIG'I`IT LI <br />O NO N" <br />�Ct PEOSON RNO PIIONE N0. 2 Sg 3161 '� <br />Heim or Craig Thompson - Dykeman Arch. <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMIN ED THIS APPLICAT�ON AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. AlL PROVISIONS O� lAWS AND <br />ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH <br />WHETHERSPECIFIEDHEREINORNOT.THEGRANTINGOFAPERMIT�OES NOT <br />PRESUME TO GIVE AUTHORIN 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 AVTHORIZ[D BY THE OV/NER OF <br />THIS PROPEFTY TO PERFORM THE WORK FOR W HICH APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 FCW AND <br />c96200 WAC. <br />i. etunvnv/nuiae[innOnai1T110R12EDAGENT DRTE <br />n <br />HOil 7 ie ykeman Architects <br />MECH NICA <br />A/C — A/HNDLG UNITS — H.F <br />FORCED A:R SYSTEMS— 8.T <br />UNITHEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATIG�J FAN <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />DIREPLACEINSERT <br />GAS <br />PERMIT S <br />TOTAI.FEE.--�.-+ 5 <br />PLA�QC N�MBi.J���l� C� I '-'"— flEi <br />{ �1 <br />" FEES VALUATION <br />! <br />BUILDING o�, <br />Q UNITS — <br />PLUMBING <br />C�STCHt �ECHANICAL <br />� ST'MF — <br />OTHER <br />STATE BUILDING SURCHAFGE <br />STATE ENEflGY SUFCHAPGE <br />PUBLIC WORKS <br />TOTAL <br />