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/APPLICkjA ION FOR CONSTR6%;TION <br />PERMIT <br />the Evergreen <br />I II II <br />CITY OF <br />everett <br />e <br />BUILDING DEPARTMENT <br />259-8810 <br />TO BE COMPLETED IN INK <br />— PLEASE PRINT <br />OWNER <br />�+iNFS SA.OdaA <br />MAN ADDRESS <br />MFFVAPI= irTycTln_ R��iUr_t___rvr-i_e.-#. <br />City <br />HIP <br />i�p_8.____341$_o('s� <br />PHONE <br />_ <br />TENANT <br />MAIL AOORESS <br />CITY <br />HIP <br />PIIDNE <br />5,4 J•l c' <br />ARCHITECT OD DESIGNER <br />MAILADDRESS <br />CIIY <br />ZIP <br />%ZONE <br />GENERAL CONTRACTOR <br />WAIL ADDRE!I <br />CITY - <br />-%IONS-----_-- <br />IICENSE• <br />MMI ADDRESS <br />UIIY <br />SIP <br />%TONG <br />UCLNyL• <br />MECHANICAL CONTRACTOR <br />PLUMBING CONTRACTOR MAIL A.GRRESS L11Y SIP PHONE LICENSE4 <br />:LASS OF WORK L <br />I_... r--I .__. _._.. n .. �......�.... i-1 .,en.�e i'l ncuro rtlnu r Cvmmirnl/FRPI_ INSERT ❑ <br />TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY <br />CONTRACT PRICE OF WORK <br />CONTACT PERSON AND PHONE NO <br />DESCRIBE WORK AND SQUARE FOOTAGE INYOL/VIEO <br />b0aDc ) )av P T o hti <br />PROPOSED USE OF BUILDING <br />I 11 �� <br />—_ <br />I HERESY CERTIFY THAT I I IAVE READ AND EXAMINED THIS APPLICATION AND <br />KNO5 AND <br />G VE KING T AND CORRECT.FWORK ILL BEIONS OF COMPLE COMPLETED <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />ORDINANCES <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY 10 VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE: OR LOCAL LAW REGULATING CONSTRUCTION OR TI HE PER- <br />FORMANCE OT CONSIFIUC7ION IIIAI I AM AUTHORIZED RY IIIE OWNER OF <br />I I IIS PROPERTY 10 PLHFOFiM INL WORK FOR WI IICI I APPLICATION IS MADE <br />AND 1 COMPLY WIl!1 IIIL STATE CONTHACIORS LAW 18.27 RCW AND <br />296 200 WAC. <br />SICNAHIHL OF CONIRAC10H ON AIIIIlU1111E11 AGENT UAIE <br />X 6- BO X`% <br />AP%ICANIB CIIY DIISINESSIICENSE NO AND BUSINESS NAME <br />LEGAL DESCRIP NOF PROPERTYISHOW BELOW OR ATTACH FOUR CO%ESI <br />LOT BLOCK of -_____._ ___.. .__.. <br />PROJECT ADDRESS <br />c - 3101 P/ <br />- <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />_ <br />_ _-_ <br />AtC --A/I l_NDLG_ UNITS__ IL_P. <br />BATHTUB <br />_FORCED AIR SYSTEMS-- BTU, M EA <br />— <br />_ <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS--ELT.U. M <br />_ <br />_ <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK& DISP. <br />VENTILATION FAN— <br />`_ <br />DISHWASHER -__---__— <br />RANGE HOOD <br />LAUNDRY TRAY <br />_—_—_- <br />_ <br />_WATER HEATER <br />_ <br />CLOTHES WASHER <br />_ <br />_1- <br />WOOD STOVE <br />TO <br />cu- <br />URINAL <br />_ <br />___ <br />METAL FIREPLACE& CHIMNEY <br />— <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT— <br />FLOOR DRAIN <br />BACKFLOWPREVENTERS <br />ROOF DRAINS - RAINLEADERS <br />SINK(SERVICE-BAR ETC)-- <br />_ <br />HEATPUMP <br />GAS PIPING <br />EXHAUST FAN <br />_.-.. <br />— <br />_ <br />- -- <br />— <br />—_- <br />- -_ <br />�.._._.. _ __ _ SUBTOTAL_,----5 <br />- PERMIT 5 <br />_ <br />SUBTOTAL - $ <br />_- <br />_---_- <br />— <br />_ <br />PERMIT 9 <br />TOTAL FEE <br />S <br />TOTAL FEE $ <br />FRONT SETBACK <br />REARSETBACK <br />SIDE SETBACK <br />PLANCHECKNUMBER <br />FEE <br />OFCEIPf NO. <br />USEZONE <br />TOTAREA <br />VACANTSITE <br />O YES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />-- - <br />TYPE OF CONS1 <br />ALLOWABLEJACTUAL <br />OCCUPANCYGROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />SIZE OF SLOG <br />NO OF STORIES <br />OYT. <br />ON <br />OCC LOAD <br />MECHANICAL <br />OTHER <br />FIRE SPRINKLERS REWIRED OYES ONO <br />HEIGHT LIMITATION <br />STATE BUILDING SURCHARGE <br />APPLICATION ACC BY PLANS APPR BY <br />STATE ENERGY SURCHARGE <br />Pl1dLIL' WORKS <br />TOTAL <br />V <br />