2710 EVERETT AVE 2016-01-01 MF Import

i �a! � ��(J��i APiPLICATI�{�� FOR CONSTRUCT�r'i"�N PERMIT � the Evergmen OVEfe�L �� CITV OF � evere�t BUILDING DEPARTMENT 259•8810 TO BE COI�PLETED IN INK—PLEASE PRINT L I DEMOLITION ❑ COMBINATION `� BUII_DING � ❑MECHANICAL ❑ PLUMBING ❑ SIGN OWhER MAILADDPE55 CITY ZIP PHONE I Ll/Jlzlzuc� ��'srX�crry•� 37//-/Zz �'=� PL SE tv��.z��T �bzob 537-9075+�" i[N�NT MAILADORE55 CI�Y ZIP PHONE �' �: APCHIIECiORDE5IGNER M�ILAODRE55 CITY ZIP PHONE i7n dc�irr L'ilnfaFu.v TYu z Goc a Y L'✓�.t<<rl 9t3zui zs'y - 3�S 6 GENERALCONTRACTOA MAILADDRE55 QTV ZIP PHONE LICENSE� ��t-�znc... CU/�'S(7��CTRN 3��/-rtz^'� /'c Sc� EvsrrEi7- 9�ui�, 357-9u79 S2`✓+�3�z�pr-T �, MECHANICALCONTR�GTOR MAILADDRESS QTV ZIP P{IONE LICENSE� ' I PLl1MBINGCONTRRGiOR MAILADDRESS CIiV 21P PHONE LICENSEI CLA55(�WORK f I NEW fJ ADDITION ❑ ALTEFATION IJ REPAIR L] DEMOLITION IJ WOODSTOVE/FRPL INSERT ❑ BUILDIN6 RELOCATIGN ' TENANT IMPROVEMENT OR INTERqR REMODEL ONLY CONT�CT PERSON AND PNONE NO. - CONTRACi PRICE OF VIORK: OESCRIBE WOFK AND SOU�RE FOOiAGE INVq.VED y j�t�I ii T /TffNO✓f E Y/5�+�6 CO4 F� B✓Lt0 �/'T •�SE � PROPOSEDUSEOFBUIIDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS I S t�ivt T APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL I LEG�I DESCRIPiION OF PHOPERTY(SHOWN BELOW OP ATT�CfI FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNIN4 THIS TYPE OF tor S{' 6 a�ocK 3S oF SwqawEec�S Z N� WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR I � NOT. THE GRANTING OF A PEHMIT DOES NOT PRESUME TO GIVE � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ', �'DD=7SuN ti EYL�r�jT WI� A��[n�=OrNa OTHER STATE OR LOCAL LAW REGUUTINCi CONSTRUCTION OR THE ', • PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE , Tp [ �- t df %tc5c.vza ' t,,, �/v� 3 OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STA7E CONTRACTORS LAW 1827 RCW AND'e96200 WAC. �� . O % l /�S F�I• ECOi1DS Or r/}�� SION�NREOFCONTRII.C�TORONAUTNORIZEDAOENT /D/A7� � YC i7 O �Vt� VN7"y f!� .S O A ��/� ' �/1 ��/� . ; PROJECT MDRESS F--��l�L'!�/1/ LoNs�t✓c rrcJN� ' � � � Z7�O ��'E!?E/T �Y6� APPLMd1NT5CITVBU51NE55LICENSENO.ANOBUSINE5SN11ME „ �. � PLUMBINO MECHANICAL • i NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE I WATER CIOSET(TOILET) � NFiNDLG UNITS—H.P. i I BATHTUB ; FOR AIR SYSTEMS—B.T.U. M E.A. � I � $ VATORY(WASH BASIN) � UNIT HE RS—B.T.U. M ' � I S ER � CLOTHES D RS � � KITCN SINK&DISP � VENTILATION FA � g DISHWAS � RANGEHOOD ' � IAUNDRYTR ; WATER HEATER ' ' '� CLOTHES WASHE � WOOD STOVE ' � �' � i I URINAL ' METAL FIREPLACE 8 CH�MNE � � � ORINKINO FOUNTAI � FIREPLACE INSERT � ' ' I � FLOOR DRAIN � HEAT PUMP � � � �'� BACKFLOW P VENTERS i GAS PIPING � ' - I� ROOF DRA S—RAINLEADERS � EXHAUST FAN � � ��i ; SINK(S VICE—BAR,ETC.) � � � � � i i i � i , . ,� � �: .i I ' ' i � i SUB TOTAL S ; SUB TOTAL S � I� PERMIT $ � PERMIT E �� — ,I TOTAL FEE $ ' TOTAL FEE S '� � I FRONTSEiB�CK REARSETBACN SIOES@iO�CK PIANCHECKNUM�ER FEE RECEIPTNO.�." " ' i u�e za+e LOT AREA VACANT SIiE FEES VALUATION FEE ' II I 1 YES I_l NO BUILDING . ' � i IYfFOfCONSCRLIOW�BLE �YPEOFCONSt.AC1URl OCNre4tr xnaOWlLLlNcuxils cnwr � PLUMBING � T � S�ZEOFOLDO. NO.OFSTORIES OASEMENi MECHANICAL � i ,I ❑ YES ❑ NO ' �I i - OCCUPRNCYLOAD FIRESPflNKLEF5RE00 HE�GH7UMITATION OTHER � i j U YES ❑ NO STATE BUILDING SURCHARGE �� II PE450N FOR SPRINKLEflS STATEENERGVSURCHARGE ' i APPI.ICA710N�CC.BY PUNS APPItOVED BY CITY OF EVERE7T PUBLIC WORKS � �cca�sa�es ' TAX CODE IS 3105 TOTAL � � ' .