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APPLICATI�.N FOR CONSTRUC7 ON PERMIT <br /> the Evergreen everett <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK�--PLEASE PRINT <br /> ❑ DEMOLITION X] COMBINATION [R BUILDING Xl MECHANICAL �7G PLUMBING O SIGN <br /> OWNEF M1ILADORESS CITV ZIP PH�NE <br /> Casa Group Corpora[ion P.O. Box 2188, Everet[, Wa. 98203 34i-3775 <br /> TENRNT MAILADDRESu CITV ZIP PNONE ' <br /> ARCHITECTOROESICaNER MAI�ADDRE55 dTV ZIP PHONE <br /> John Kappler 7981 168[h Ave.N.E., Re�nond, Wa. 98052 883-9724 <br /> GENEHAL CIXJTAACTOR MAIL ADDRE55 CITV ZIP PHONE LICENSE I <br /> Casa Group Corp. P.O. Box 2188, Everett, Wa. 98203 347-3775 CASA(lC�r153� <br /> MECHANICALCONTFFCTON MAILADDRE55 CITV ZIP PHONE UCENSE� <br /> Everrtreen StaCe Sheel Metal, P.O. Box I508, Everett, Wa. 98206 252-3114 EVERGSS-121K7 <br /> PLUMBING CONiRACTOR MAIL ADDRE55 CITV ZIP PHONE LICENSE• <br /> Robinson Plurbine. Inc. 607 SE Everett Mall Wav Evt., Wa. 98208 355-6171 R09II�272C2 <br /> CUSS OF WOPK <br /> '� NEW ❑ ADDITION ❑ ALTERAT�ON ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> TENANT ItAPROYEAIENT OR INTERIOR REMODEL ONLY ` i1�.� 'Et�NTACT PERSON AND PHONE NO. i <br /> �JJ' <br /> CONTMCTPRICEOFWORK: [ � J Ri.chard E . Jones . 347-3775 <br /> LESCRIBE WORK AND SOUARE FOOTRGE INVOLVED <br /> PROPOSEOUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TU BE TRUE AND CORRECT.ALL <br /> IEGRLDESCFIPTIONOFPROPEFiV�SHOWNOELOWOP.ATfACHFOUPCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WF!ETHER SPECIFIED HEREIN OR <br /> �or 2 a�ocrc oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROV�SIONS OF ANY � <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE �, <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TF'E <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> � SIGNAIDREOFCONTRACTORORAUTHORIZEDAGENT DATE <br /> PRp1ECT AODRE55 �������L� �� f/'l�// C <br /> 1618 En land Ave . , Evere[ t , Wa . "�as"aTs�Lou�"'ES5JOL50LaC101nES$NAME ��op0801 <br /> l. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OP FIXTURE OR ITEM FEE MO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) �� NC—A/HNDLG UNITS—H.P. � I <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � � <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; , <br /> SHOWER � ' CLOTHES DRYERS � <br /> KITCHEN SINK 8�ISP ; VENTILATION FAN ; ', <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> CLOTHES WASHER N/OOD STOVE i <br /> URINAL � ' � METAL FIREPLACE 8 CHIMNEY � <br /> DFINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP r <br /> BACKFLOW PREVENTERS ; I GAS PIPING ; <br /> ' ROOF DRAINS—RAINLEADERS � 4 EXHAUST FAN -T <br /> $INK(SERVICE—BAR,ETC.) ; � 2 5an. Li-re�l-a��- —� <br /> � � <br /> T <br /> 1 <br /> 1 1 <br /> 1 1 <br /> SUBTOTAL 3 ; SUBTOTAL 5 <br /> PERMIT $ � PERMIT 5 � <br /> TOTAL FEE $ ' TOTAI.FEE $ �' <br /> FRONTSETBACN PEARSETOACK SIDESETBACN �PLr(.fN �HE �jUM /Ry�� FcE O PECEIPTNO <br /> 20 /ll 6 0 `7C./ OC�C..L/� �D C�� ��„�' , <br /> USEZONE LOTARE VACANTSITE FEES VALUATION FEE � <br /> —� �L lb� � ves ❑ No euaow� '�,•o° lerr cr ,t � `Id!— ' <br /> TYPEOFCONSi.ALLOWABIE ttPEOfCONSTALIDAL oc[uvuxr HOIXmvtIIAGUNrtS <br /> LPOu� I � <br /> _� ,3 PLUMBING � <br /> SIZEOFBLDG NO.OFSTORIES �ASEMENT MECHANICAL � <br /> 383u SF YES ❑ No <br /> OCCUPAN VLOAD FIRESPRNNLERSREO'D HEIGHTLIMITATION Z OTHER —;—� <br /> � YES ❑ NO P e r P 1 O C p 1 a n STATE BUILDING SURCHAfiGE �5 <br /> RFASON FOR SPRINKlERS <br /> Fire marshall requiremen[ STATEENERGVSURCHARGE ; <br /> �PPLICATI�.BY PUNSAPPROVEOBY CITY OF EVERETT PUBLIC WORKS � <br /> 4� LOCALSALES � <br /> TAX CODEIS 3105 TOTAL <br /> � 507,33 ciec��f ,� o�e��7py�(Pdf o� p(au Cluc�C -'/.�a I <br />