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`herE°gteC 'NSTRUCTION y C <br />ev -8745 PERMIT PERMITNQ: 9`�79 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL '❑ PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Eyes of Everett 9610 Evergreen Way Everett, WA 98203 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Tube Art RIZI&XVXXX -808 Aloha St. Seattle, WA 98109 284-0421 TUBEAO*311QS <br />"I <br />M <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />j7 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />$ 7600.00 <br />Tnstall illuminated <br />on two elevations, install customers S/F <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Optometrist <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CFIRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PE CE DF f�UCTION. <br />SIG FACTOR, D ENT.O OWNER DATE <br />- <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />fo1U <br />OF ADDRESS <br />-f�0"Evergreen Way <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - A/HNDLG UNITS - H.P. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS- B IF UIH P. <br />SHOWER <br />GAS FIRED ABC. UNITS — B T.U. <br />_ <br />KITCHEN SINK 8 DISP. <br />FORCE? AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS —BT. U. M <br />CLOTHES WASHER <br />EVAPORATIVc COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />$ <br />SUBTOTAL <br />PERMIT <br />f <br />1 <br />PERMIT <br />TOTAL FEE <br />$ <br />1 <br />TOTAL FEE <br />FRONT SETBACK <br />REAR SETBACK SIDE <br />SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑CA ❑No <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$7600 DD <br />27 <br />00 <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO <br />INVESTIGATION FEE <br />Sec. 304(c) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />PLANSCHECKED DY <br />B.E. <br />APPR. FOR ISSUANCE BY <br />BE.. <br />PERMITS.H. <br />FDRIEWAY <br />AL <br />27 <br />00 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IN THIS SPACE) THIS 15 YUUH rtnmu (7) <br />C�— <br />LS <br />ui <br />r� <br />