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theEvo-green <br />CITY OF <br />everett <br />259-8745 <br />C"MSTRUCTION <br />PERMIT <br />PERMIT NQ. 17 4 U 3 <br />❑ DEMOLITION ❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Richard A. Woolworth 3008 S Lk. Cassidy Rd. Lake Stevens 98258 335-0800 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY IIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY -.y PHONE LICENSE r <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY LIP PHOth LICENSE . <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION 91 ALTERATION ❑ REPAIR ❑ DEMOLITION E, BUILDING RELOCATION <br />VALUATION OF WORK <br />S 950.00 <br />DESCRIBE WORK -- <br />Add door and two windows in place of garage door. Add one 11 x 11 room at back of garage <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Storage and shop <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAM!NED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. 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 PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE ONTRACTOR, HBO IZED AGENT. OR DATE <br />X <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />RR 28,29,30 xkak Block 433 Everett Div B <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />2108 Hoyt <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <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.T.U./H.P. <br />SHOWER <br />GAS FIRED A.C. UNITS — B.T.U. <br />KITCHEN SINK d DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PHEVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE d CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST AN <br />SUBTOTAL <br />$ <br />SUB TOTAL <br />PERMIT <br />$ <br />PERMIT <br />TOTALFEE <br />$ <br />TOTALFEE <br />FRONT SETBACK <br />REAR CETRACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ❑No <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />��� 3C1 <br />PM 000RH29995 <br />nvr <br />043 <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 />ELDG $ <br />.00 <br />FIRE SPRINKLERS REOUIRED ❑ YES 0 NO <br />ipjk dlfu)di.9kWX PENAL <br />YF4Kx== $- <br />•DO 25 <br />00 <br />STATE BUILDING SURCHARGE <br />CAsH $Z <br />1.50 1 <br />50 <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />L.C. <br />DRIVEWAY PERMIT <br />— <br />TOTAL <br />51150 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IIN THIS SPACE) THIS IS YOUR PERMIT <br />LY-J <br />WORK STARTED WITHOUT PERMIT <br />cf- <br />L�- <br />ni <br />ADDRESS FILE <br />