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APPLICAT1614 FOR CONSTRUCT wJN PERMIT L°VeE�lt <br />i1 TO BE COMPLETED IN INK —PLEASE PRINT <br />me Evergreen <br />CITY OF <br />everett HEATING SYSTEM: EGA$ ELECTRIC Ll -- <br />j BUILDING DEPARTMENT----/� <br />259-0810 IN � �"� 1 � ��� `�( <br />I I DEMOLITION COMBINATION BUILDING MECHANICAL L PLUMBING SIGN <br />OWNER (./O Mj PV W LA - CITY ZIP PHONE <br />`3NDIwr�Is_( 1at1�� -2p��ry.�, Iry_t31,N�X �� >✓� 6,,h �? <br />�• � � <br />'I TENANT MAILAODRESS 3auv F'-fice.,T9 LAV,"svi..`' 'MTL L.JA. f Q-2ul <br />ARC'IU-C •E/CAy'T"Oo�R DEBIGNEPn^_` MAIL AOORf.55 ,LA!, T CITY ••�[^�.: Zlr p�/ p�P�HONE c 5;22.-Z f/5L3 <br />GENE�AI. COrI1 CTOR F'T�F-Lt So �.4-(L CL�`FCIT-r GD� ZIP PHONE <br />�./y 1 !Lti11�E <br />90 3z-��gp <br />vxJ_����� Poc�E�X �i�ti�l SF,47: %-SLVn_ 4 t� <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHI5�-[Jt-ICFNSE�h t�"t <br />[.L�R) li 1 r•3 G"iu11�'L� G(3Aq.1-l-C�( �rS_j�.��11�U ���( �l Cv i•i (G iilil�ta.td� 9' <br />PLUMBING CON TRAC I OR MAIL ADDRESS CITY ZIP PHONE IICENSEA <br />GLASS OF WORN <br />I I nooA,o nGA1nI InnN wf)nl]STOVFrFRPL INSERT I I BUILDING RELOCATION <br />I 1 IY." ZAvi nu/u►...v.. I.........­- <br />H V fYL ('arlZ V 1 !!��` ��� �IU� <br />Qj7 PERSON ANU PHONE NO <br />FI <br />CONTRACT PRICEOP WORN 7�1 ` �E000 <br />�Il�� C <br />DESCRIBE WORK ANO SQUARE FOOTAGE INVOLVED <br />sz�F 1, r� ��,�aA&Zto tJ <br />PROPOSED USE Or BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />U JLj l-}V V S (` <br />_ <br />APPLICATICN AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />THIS TYPE OF <br />LeaLDESCRIPTION OFPROPERTY (SHOWN BELOW oRATTACNFouRCOPIES) <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING <br />WORK=WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LOT BLOCK Or <br />N - T. THE GRANTING OF A PERMIT DOES NOI PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />SACT( ( L <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />-�� - <br />PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AT""' 00 WAC. <br />AUTHORIZED AGENT DATE 7-Z%-w <br />SIGNATURE OF CONIRACTOROR <br />PROJECT AGGRESS% /S / 6�r��'./ <br />Am CAANIS.5 F EN U S <br />C <br />PLUMBING <br />` <br />MECHNO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO.PE <br />OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIC-AJHNDLG UNITS-H.P. <br />I <br />BATfiTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />' <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />i <br />SNOWED <br />CLOTHES DRYERS <br />' <br />KITCHEN SINK & DISP <br />VENTILATION FAN _ <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />' <br />WATER _ <br />ER HEATER <br />/Q <br />CLOTHES WASHER <br />per. <br />W9Q�'STdVE ri U N[ <br />7 5 r <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />' <br />CHINKING FOUNTAIN <br />FIREPLACE INSERT <br />—�— <br />FLOOR DRAIN <br />HEAT PUMP <br />'• <br />BACKFLOW PREVENTERS <br />CAS PIPING <br />ROOF DRAINS-RAINI EADERS <br />�— <br />EXHAUST FAN_ <br />_ <br />SINK (SERVICE -BAR, ETC.) <br />` 1 <br />T <br />- <br />, <br />' <br />�QQ <br />SUB TOTAL $ <br />' <br />SUB TOTAL S <br />l) p <br />PERMIT 5 <br />PERMIT $ <br />, <br />TOTAL FEE $ <br />TOTAL FEE $ <br />y oa <br />w v. <br />rvn v1 I w <br />FRONT SETBACK <br />••—•• <br />REAR SETBACK <br />SOESETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPTNO. <br />usEzoNE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />--- <br />PLUMBING <br />_ <br />TYPE GF CONIS ALLOWABLE <br />TYPE Or CONSI. ACTUAL <br />OGUruxr <br />1iRD1" <br />MO OI VARUYO urns <br />MECHANICAL <br />�_— <br />�_ <br />9ZE OF BLDG. <br />NO. OF STORIES <br />BASEMENT <br />ADDITIONAL PLAN CHECK <br />_ <br />OCCUPANCY LOAD FIRE SPRNKLERS REO D HEIGHT LIMITATION <br />REASON FOR SPRINKLERS <br />OTHER <br />STATE BUILDING SURCHARGE <br />INT�KEev <br />PLANSAPPROVEOBY <br />CITY OFEVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />