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� ,^. <br />.�. <br />APPLICATIt�A �OR CO�IST�UCT �ON �ERMIT <br />Ihe Evergreen <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />c����_ <br />TO BE COMPLETED IN IirK—PLEASt PRINT <br />everett <br />� <br />L! DEMOLITION � COMBINATION �� BUILDING _ MECHANICAL G PLUMBING ❑ SIGI� <br />OWNERI,y�F g M4ILAOORESS CITV ZIP P�ONE <br />�9fiBk3sd ,Yi✓ �31.ryyvK�¢oPert�es l�+ [7ox a�b� �'verel7' u��v 98ao3 oZo6� •�S - H 7a.5- <br />TENANT MAILADUPESS CITV ZIF PMONE <br />ARCHITIdCTORDE5IGNER MAILADDRE55 <br />C�fV 21P PMONE <br />GENERaLCONTRACTOR � MAILA�DRE55 C:tt ZIP PHONE LICENSEa <br />S/9-/n � /f� RBcuE _ <br />MECHANICALCONTRA:TOP MFILAODFE55 CITV ZIP PMONE LIGLNS_a <br />PWMBINGLONTRACTOR MAIL <br />arv <br />PMONE LICr-y5:� <br />i�� NEW ❑ ADDITION f:' ALTERATION LI FlFPAIR _ C� DEMOLITION '_ :� WOODSTOVE/FRr^L INSEflT ❑ BUILDING RELOCATION <br />TENANT IMPFOVEMENT Ofl INTERIOR REMODEI ONI.Y / CONTACT PEPSON AND PHONE NO. <br />�,w,e,..roo���.,�w„o�. .�i- �Zo�L I LYi� � �.t�l�� .�^'/7TS - - <br />s. G R, ia ��f s� ��- <br />PROPOSED USE OF BUILUING <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN OELOW OQR ATTACH FOUR COPIES) <br />LOT� BIOLI: ��O OF Q6!///'�#' I�C%G <br />S�_B-Tr.rc6��D �R G�o�P�o�e <br />p@ �1L RiGN %�/e . <br />Si� �Za2- - <br />PRQIECTA00RES5 � <br />75�0� Lou�e� i�:�� l50�''� i <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM F <br />WATER:.LOSET(TOILET) I <br />BATHTUB W/J OU/a� <br />LAVATORY (WASH BASIN) // _ <br />SHOWER <br />J KITCHEN SINK 8 DISP <br />DISHWASHER / <br />LAUNDRYTRAY <br />CLOTHES WASHER I <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />SUB TOTAL $ _L <br />PERMIT S <br />FRONTSETBACK <br />� � <br />USE 20NE <br />�.Z <br />NPE TMOF CONS,i. 1ALLOWABIE <br />.LL—N <br />����LDSf <br />46o SF �42 <br />OCCUPANCVLOAD <br />N/Q <br />REASON FOR SPRINKLERS <br />APPLICATION ACC. BY <br />TOTAL <br />REAR SEnTBA^CK <br />I�' <br />LOT AREA <br />�333 <br />fVPE Of CONST. ACTIIAL <br />� � <br />NO.OF STORIES <br />� <br />FIRE SPRNnLERS REO'D <br />❑ ves �No <br />PLiNS AP�PQVE� BV <br />SIDE SETBACN <br />C � <br />VAC�A�N�T E <br />f✓1'ES L NO <br />OCLUP�INCY NOOfDWFIUNGUNiiS <br />DASEMENT , <br />❑ YES !�NO <br />HEIGHT L:lAITATION <br />r �l !� � <br />CITY OF EVERETi <br />:OCALSALES <br />TAX CODE IS 3105 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLIC.�TION ANU KNOW THE SAME TO BE TRUE ANC CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TY°E OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIF�ED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES fJOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL TH[ PROVISIONS OF ANY <br />OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE <br />PERFOPMANCE OF CONSTRUCTION. THAT I AM PUTHORIZED BY THE <br />OWNER OF THI: PROPERTY TO P�RFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAGTORS LAW 1827 RCW AND 296200 WAC. �� <br />SIGN�TU��/7 Tq.�JL//�IL �E�t/iNiYi/�T ��i`r' " P.r <br />,�Gr �i� �a�d��/�S� <br />P ICANTS CITV BUSIN55S LIC2NSE NO. AN� BUSINESS DIAME <br />FORCED AIR SYSTEMS—B.T.U. M <br />UNIT HEATERS—B.T.U. M / <br />CLOTHES DRYERS / <br />VENTILATION FAN <br />RANGEHOOD / <br />METAL FIREPLACE & <br />'PUMP <br />PIPING <br />\UST FAN <br />5 I /D/) � —' <br />PL4N CME K NIl BER FEE RECEIPT NO. <br />a'3 a��. � aa� <br />FEES VAILUATION FEE <br />BUILDING z � ' <br />1 <br />PLUMBING � � <br />(J� <br />MECHANICAL ' <br />,auw�/IIbOU � � <br />i <br />STATE BUILDING SURCHARGE � <br />—� ) � <br />��v� o , � � 2 � <br />PUBLIf. N/ORKS L O � <br />— /��) �� <br />TOTAL (;i G(�' <br />