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9 y <br />H <br />JD <br />E_- <br />l-3 Tn <br />r H H EH <br />I-3 w <br />IVHsJ <br />1-3NH <br />C <br />HC <br />W O8 <br />ZH <br />t" H H <br />N <br />H <br />nd� <br />z H3 En <br />H O aJ <br />r A� <br />off <br />APPLIC„nON FOR CONSTRUCTION <br />PERMIT <br />the Evergreen <br />I verel( <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />259.8810 <br />OWNER <br />AUIL ADDRESS G:� LIP PHONE <br />7509 Highland Drive Everett 98203 347- 5984 <br />Janeen Byrnes <br />ZIP PHONE <br />TENANT <br />MAILADDRESS GIY <br />ARCHITEQ OR DESIGNER <br />MAIL AGGRESS CITY ZIP PHONE <br />GENERAL CANIRACTOR <br />MAR ADDRESS CITY ^Z`IP,^^ PHONE LICENSE• <br />nen -JAc� T: cTT:Drn.�RM Pl7 <br />LICENSE <br />MUMS INOCONTFACTOR <br />MAIL ADDRESS CITY 21P PHONE <br />SSOFWORK 1 _ 1-1 mnvcmePl INSPRT ❑ BUILDING RELOCATION <br />❑ NEW ❑ ADDITION ALTERATION TiON <br />TgryrAci PERSON AND PHONE NQ <br />TENANT IMPROVEMENT ORINTERIOR REMODELONLY <br />CONTRACTPRICEOFMORK 6 675.00 <br />DESCRIBE WORK ANO SQUARE FOO GE INVOLVED <br />Foundation — <br />AND <br />THAT HAVE READ AND EXAMINED THIS7AN <br />PROPOSEDUSEOFBUILDING <br />,. <br />THEREBY CERTIFY <br />KNOW THE SAME TO BE7RUEAND CORRECT. ALL PROVISIANDI' <br />TYPE OF WORK WILL BEITHLEGAL <br />•1G�FMj` '� <br />ORDINANCES GOVERNING THIS <br />NOT <br />DESCRI TION OF VRovcatt lS Dw eELow DRA ACN FDuncoPlEs <br />WHETHER SPECIFIED HEREIN OR NOT. THEGRANTING OFA <br />GIVE AUTHORITY TO VIOLATE OR CANCEL TS OFLOT <br />PRESUME TO <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR HPER- <br />BLOCK OF <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF <br />THE WORK FOR <br />PHCIWMADE <br />THIS PIRCOMPLYTWITHPERFORM <br />AND STATE CONTRACTORS 1827 ND <br />296.200 WAG <br />SIGNATURE OR AUTHORIZED AGENT DATE <br />JNIRACIOR <br />X S_ <br />PROJECT ADDRESS <br />APPLICANTSCITY BUSIN S LIa.,� DBUSINESS NAME <br />7509 Highland Drive Everett, <br />Ida. <br />MECHANICAL <br />PLUMBING <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />AJC— AIHNDLG UNITS—H.P. <br />WATER CLOSET (To" <br />- <br />FORCED AIR SYSTEMS— BTU. M EA <br />BATHTUB <br />—B.T.U. M <br />LAVATORY (WASH BASIN) <br />DRY <br />CLOTHES DRYERS <br />CLOTHES <br />SHOWER <br />VENTILATION FAN <br />KITCHEN SINK 8 DISP. <br />RANGE HOOD <br />DISHWASHER <br />WATER HEATER <br />LAUNDRYTRAY <br />WOODSTOVE <br />CLOTHES WASHER <br />METAL FIREPLACE 6 CHIMNEY <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />GAS PIPING <br />BACKFLOW PREVENTERS <br />ROOF DRAINS— RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE BAR. ETC.) <br />SUBTOTAL <br />$ <br />SUBTOTAL <br />$ <br />PERMIT <br />S <br />PERMIT <br />S <br />TOTAL <br />FEE <br />S <br />TOTAL FEE <br />SET <br />FRONTSETBACK REAR BACK <br />5 <br />A SETBACK <br />PUNCHEC UMBER <br />J[Vc`9 <br />FE! <br />S�5 <br />RECEIPT NO. <br />a <br />So' 20i <br />c' <br />USEUSE ZON '_OT AREA <br />VACANT ITS <br />t YES O <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />TYPEOFCONST C A CYGROUP <br />NO Of OWELLIND UNITS <br />ALLOWABLE(�DIlUI� Li_3 <br />PLUMBING <br />SIZE OF BLDQ NO OF STORIES BSMT. <br />DEC LOAD <br />MECHANICAL <br />/ <br />f <br />I- <br />O <br />8 / N <br />I <br />NEKiNTLIMITATION <br />OTHER _ <br />TIRE SPRINKLERS REWIRED 0YE9 yt N-0 <br />STATE BOIL ING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BV PLANS APPR BY <br />PUBLICWORKS <br />M 111 5Z- 1 <br />TOTAL <br />