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the Evergreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />■i■�� <br />-� ��r �o�� D <br />APPLICAI iON FOR CON�TRU1� <br />PERMIT APd U I 1989 <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />........ ....................................................._... .everett <br />Gi f Y Ur EVERETT � <br />ruolic vYorks Dept. <br />OWNER MAILADOPE55 GIiY 21P PHONE <br />Everett Public Library 9512 Evergreen WAy Everett 98204 <br />TENANT MAILAODFE55 CITY ZIP PHONE <br />ARCHITECTOROESIGNER MAILAOOflE55 CITY ZIP PHONE <br />The Dykeman Architects 1602 Hewitt 1l400 Evetett, 98201 <br />GENEFr1LCONTPACTOR MAILq00RE55 CITY ZiP PMONE LICENSE� <br />Stan Palmer Const. P. 0. Box 2057 Silverdale �206) 692-6526 STANPC*202NF <br />MECHRNIGALCONTRACTOR MRILADDBE55 CITY 21P PMONE LICENSE• <br />PLUMBINGCONTRAGTOR MAILADORESS CITV 21P PMONE LICENSE+ <br />R C Mechanical, Inc. 6720 210th St. SW II204 Lynnwood, 98036-7330 (206) 670-2009 RCMECI*120L4 <br />� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />:ONTRACT PPIGE OF WORK <br />DESLRIBE WOHK r1N0 SOUARE FOOUGE II <br />Mechanical <br />PROPOSED USE OF BUIL�ING <br />Library <br />IEGAL DESCRIPTION OF PROPERTV (SIIOV <br />LOT BIOGK OF <br />PFOJELTAODRESS <br />9512 Evergreen Way <br />PLUMBING <br />NO. TYPE OF FI7(TUHE ON ITEM <br />WATER CLOSET(TOILEn <br />BATHTUB <br />LAVATORV(WASH EASIN) <br />SHOWER <br />KITCHEN SINKB DISP. <br />DISHWASHEP <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />SUBTOTAL 5 _ <br />PERMIT 5 _ <br />TOTALFEE 5 <br />qFqRSETBPGK SiOESETBACY. <br />�OTARER VAGANTSITE <br />❑ YES ❑ NO <br />OLCUPANCYGROUP NO.OiOWEILI! <br />NO.OFSTOPIES BSMi. OCC.LOAD <br />❑ Y <br />❑N <br />HEIGMT LIMITAT <br />❑ YES ❑ NO <br />PLRNSAP� �f <br />W <br />I HERERY CERTIFV THAT I HAVE READ AND EaAMIN ED THIS APPLICATION AND <br />KNOW IHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br />ORDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH <br />W HETHER SPECIFIED HEREIN OR NUT. THE GRANTINC� OFA PERMIT DOES NOT <br />PRESU ME TO GIVE AUTHORITV TO VIOLATE OR CPNCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTI �N OR THE PER� <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERN TO PERFORM THE WORK FOR WHICN APPLICATION IS MADE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296200 WAC. Qo <br />SIGNRTUREOFCONTFRCTORORAUTHORIZEDAGENT OATE �-J~-[ / <br />�i�. � � , �� <br />APPL NTSCITYBUSWEo UCENSENO.ANDB INESSNRME <br />MECHANICIIL <br />NO. TYPE OF E�UIPI <br />2 A/C—A/HNDLGUNITS—H.F <br />FORCED AIR SYSTEMS— 8.T <br />UNITHEATERS—B.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />METAI FIFEPLACE � <br />FIREPLACEINSERT <br />GAS PIPING_ <br />EXHAUST FAN <br />SU8 TOTAL <br />PERMIT <br />TOTAL FEE <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTfiER <br />STATE BUILDING SURCH�.RGE <br />STATE ENERGY SURCHAFGE <br />PUBLIC WORKS <br />TOTAL <br />fn�l <br />S <br />S <br />FEE <br />