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� <br />APPLICATI� N FOR CONSTRUC'R ON PERMIT everett <br />1he Evergraen TO BE COMPLETED IN INK— LEASE PRIN n',n J� � <br />CITV OF / p V� ' <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />DEMOLITION COMBINATION <br />HEATING SYSTEM: ❑ GAS ELECTRIC ❑ <br />�_': MECHANICAL _: PLUMBRJG �; SIGN <br />OWNEtl MAILApDRE55 �ITV 21P `�/ PHONE <br />���k C. HEID (`IIoSIs�Pc Sw L`li•a rs wrl _f�`�3 �t9 Lo77 <br />TENANT MAILA�DRESS CITV ZIP PHONE ' <br />� � ! � <br />ARCHITECTOROESIGNEF MAILADDRESS CITV 21P PdONE <br />� � I I <br />GENERALCONiRAGTOR MAILAODRESS QiV ZIP I.iONE LICENSEI <br />�� .�J•1�,n <br />MELMANICALCONTiqCTOR MAILAODRESS CIiY 21P PHONE <br />PLUMBINGCONTPACTOR MNLADDRFFS GITV ZIP PHONE <br />CLASS OF WOflN <br />: NEW <br />� �� <br />CONTRACT PqICF <br />�ESCRIBE WORK <br />/NSi BE <br />PROPOSEO USE ( <br />J %�� <br />LEGAL DESCRIPTI <br />ior <br />II <br />�DDITION . ' AL7ERATION <br />S"l-�-�_f� <br />WOflK � 30J %S/O <br />� SOUAf'E FOOTAGE INVOLVED <br />ADORE55 <br />.^..$% <br />PROPERiY (SHOWN BELOW OR ATfACH <br />BLOCK OF <br />TYPE OF <br />WATER CLOSET i <br />KITCHEN SINY; 8 DI <br />DISHWASHER <br />LAUNDRYTRAY <br />C�OTHES WASHER <br />URINAL <br />ROOF <br />SINK 6 <br />M <br />UCENSE• <br />�. . HEPAIR .. DEMOLITION ''�. WOODSTOVE/FRPL INSERT .J BUILDWG RELOCATION <br />I CONTACT PEPSON AND PMONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXP.MINED THIS <br />APPLICATION .:ND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />COPIES� PROVISIONS OF LAWS AND OR�INANCES GOVEflNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />.� �P OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />ONNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />— APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 2g6200 WAC. <br />SIGNATUREOFCONTRACiORORAUTHORIZEOAGENT DRTE <br />X (�'��� I�1�r.� <br />W/F 9�ti •1V 3 APPIICANTS CITV 9USINESS UCEHSE NO. ANO BUSINE55 NAME <br />ITEM � FEE <br />FOR OFFICE USE ONl.Y: <br />FRONTSETBACK REARSETH4CH <br />z� w <br />USEZpONE �nTpqEq <br />v\�I <br />iYPE OF CONiS. ALlOWA9l( iyPE Of GONST ACiUAL <br />SRE OF BL�G. NO.OF STORIFS <br />672 S.f qan Z <br />: co� a c <br />OCCUPANGYLOFD FIRESPRhKLERSREO'D <br />^IJ <br />fiEASON FOR SPRINKLERS <br />INtAKE 9Y <br />)TAL $ <br />f $ <br />FEE $ <br />�NS APPROVED BY <br />�� ��2 S <br />A/(:—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DFYERS <br />VENTILATION FAN <br />FANGEHOOD <br />WATEH HEATER <br />WOOD STOVE <br />MF.TAL FIREPLACE & CHIMNEY <br />GAS PIPING <br />EXHAUSTFAN <br />SIOESETBACK PLANCHECK 9MBER <br />s ci - <br />VAC�NT SRE EES <br />h BUILDING <br />OLLpGR4Y NO Oip1V[LLINGONOS <br />r,aou� / <br />PLUMBING <br />BASEMENT MECHANICAL <br />� <br />HEiGnT2 ir$qT�on ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVEflETT pUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />FEE <br />FEE <br />SUB TOTAL 3 — <br />PERMIT $ J- <br />TOTAL FEE $ i� � — <br />Gy <br />H <br />