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APPLICC""ON FOR CONSTRf ;TION <br />PERMIT <br />the Evergreen <br />CITY OF <br />L•verett <br />everett e <br />BUILDING DEPARTMENT <br />259.8810 TO BE COMPLETED IN INK — PLEASE PRINT <br />OWNER <br />Tim Williamson <br />MAIL ADDRESS <br />2906 Hoyt <br />CITY <br />Everett <br />ZIP <br />98201 <br />PHONE <br />258-2590 <br />TENANT <br />Impression Design <br />MAIL ADDRESS <br />Jat:kson <br />Everett- <br />zip <br />98201 <br />.__ <br />PHO2229 <br />355-3200 <br />ARCHITECT OR DESIGNER <br />AWL ADDRESS <br />CITY <br />ZIP <br />E <br />Ilawg Construction <br />2906 Hoyt <br />Everett <br />98201 <br />258-2590 HAWG**13002 <br />GENERAL CONTRACTOR <br />Lukes M&M Electric <br />MAILADDRESS <br />13011 Hwy. 99 South <br />Everett <br />98204 <br />PHONE LICENSE. <br />743-6063 LUKESM*285BC <br />LICENSE . <br />Puget Sound Plumbing 2024 Casino Rd. Everett 9k04 7479537 30-034-409 <br />PLUM81NO CONTRACTOR MALADDRESS CITY ZIP PIKTIBE LICENSE. <br />® NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITInN I -I <br />IENANTIMPROVEMENTORINTERIOR REMODEL ONLY <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND 9OUME FOOTApE INYOI ED <br />FRo1g7BED WEGF BuaowG <br />�� <br />_sJ1- 1� <br />(�xx'tI � <br />j <br />�V 1 <br />JJ <br />iY <br />CONTACT`PERSON AND PHONE NO. (y� /,/y��(p' <br />�I V� L _-__JII �I _ I✓LV _- <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE OOMPL-TED WITH <br />WHETHER SPECIFIED HEREINOR NOT. THE GRANTING OFA <br />PRESUME TO GIVE AUTHORITY O VIOLATE OR CANCEL THEPROVIRMIT �ONS OF <br />ANYOTHER STATEOR LOCALLAW REGULATING CONSTRUCTON OR THE PEW <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TIIE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FOR WHIC PPUCATION IS MADE <br />AND I COMPLY WITH THE STATE CONT 1111,27 RCW AND <br />296.200WAG <br />VGNATUREOYTMCTOROIi AUTNORI7,E GENT DATE <br />T�ICAA..IV" U'1.]II(IIC�IIYI� O7e•343/3o%P9 <br />LEGAL DESCRIPTION OF FYIOPEgIY'g7MOWN BELOW OR ATTACH FOUR COPIESI <br />LOT 4 BLOCKhrt. Plf�F AP#8811010069 <br />- <br />Lot 1-7 Blk. 6 Beverly Pk. <br />Short Plat Puget Dr. <br />' <br />PROJECTADDREBS <br />1 <br />AMICANTS PITY BUSINESS LICENSE NO AND BUSINE88 <br />MECHANICAL <br />PLUMING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />A/C - A/HNDLG UNITS -H.P. <br />FEE <br />3 <br />WATER CLOSET(TOILETI <br />2 <br />BATHTUB <br />7 <br />I <br />FORCED AIR SYSTEMS - BTU. M E0. <br />�- <br />3 <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS -ST.U. M <br />SHOWER - <br />1 <br />CLOTHESDRYERS <br />1 <br />KITCHEN SINK& DISP. <br />2 <br />VENTILATION FAN <br />- <br />1 <br />DISHWASHER <br />_ <br />1 <br />RANGE HOOD <br />L.')NDRY TRAY <br />1 <br />WATER HEATER <br />1 <br />CLOTHESWASHER <br />WOOD STOVE <br />URINAL <br />DRINKING FOUNTAIN <br />_ <br />j <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING_ <br />EXHAUST FAN <br />_ <br />ROOF DRAINS-- RAINLEADERS <br />SINK (SERVICE - BAR. ETC) <br />_ <br />SUBTOTAL <br />PERMIT _ <br />f <br />f <br />_ <br />- <br />SUBTOTAL $ <br />PERMIT f <br />_ <br />JQ <br />FRONT SETBACK <br />TOTAL FEE <br />NEAR SETBACK <br />$ <br />SIDE SETBACK <br />_ <br />_ <br />I TOTAL <br />PLAN CHECK kukykn <br />FEES <br />FEE <br />FEE <br />VALUATION <br />f <br />RECEIPT no <br />FEE <br />USE ZONE e� <br />Z I <br />LOT AREA - <br />�-7, Oc <br />CANT SITE <br />YES ❑ NO <br />BUILDING <br />- <br />C <br />11 <br />4G--- <br />TYPE OF LONST <br />ALLOWABLEIACTUAI-�- <br />'F <br />OCCUPANCY <br />A'^3 <br />NO OF DWELLING UNITS <br />/ <br />-- <br />PLUMBING <br />y,J <br />BRE OF BLDG. NO OF STORIES "MY. <br />i` Y�51 4/ <br />''V0�JF GAJGZ• <br />FIRE SPRINKLERS REWIRED OYES YNO <br />OCC LOAD <br />,y� <br />MECHANICAL <br />HEIGHT LIMITAi1DN <br />? <br />OTHER <br />p <br />1 <br />STATE B LDING SURCHARGE <br />_ <br />APPLICATION ACC, BY <br />BY PLANE APPR. BY <br />/� <br />M��VF S d`_ <br />ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />