Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT. WA 98201 <br />C0411STRUCTION <br />PERMIT <br />❑ COMBINATION U EIUILDING ❑ MECHANICAL <br />PERMIT NIO. 07344 <br />❑ PLUMBING <br />OWNER MAIL ADORF 35 CIT i ZIP VIIONf <br />W. D. Tackitt 337-1234 <br />ARCHITECT Ofl DEGIGNER MAIL ADDRESS CITY ZIP -PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑NEW ❑ADDITION ERXTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />S <br />DESCRIBE WORK <br />Alteration of existing building ---- Add to Permit #7280 <br />PROPOSED USE OF BUILDING <br />commercial <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. 'iHE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CO TRACTOR OR BL:NC/ 11 DACE NT DATE <br />X 14 ] � J fC <br />LEGALDESCRIPTION OFPROrERTY(SHOW BELOW OR ATTACH FOUR COPIES) <br />LOr BL"K—OF <br />JOB ADDRESS <br />9506 19th Avenue S.E. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />F_E'6 <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />—` <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />— <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DFAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />_ <br />S'NK (SERVICE — BAR. ETC.) <br />SUBTOTAL <br />SUBTOTAL $ <br />_ <br />PERMIT <br />S <br />PERMIT $ <br />_ <br />I <br />TOTAL FEE <br />$I <br />TOTAL <br />FEE $ <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF UVIRLING UNITS <br />BUILDING <br />$ <br />34 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES :]NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.G. <br />SEC. 303 (a) <br />2, BUILDING PLANS <br />TOTAL <br />34 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIV ACCEIATHIS IS YOUR PER <br />YY UQ 3'BI M M -- <br />00 <br />ki�Ot,U♦R REC/��! PT� CDPPR. <br />� C i /��� K Y�/ U <br />6. DRAINAGEd- <br />7. cNVIRONMENTAL IMPACT STATEMENT <br />8, HEALTH DISTRICT_ <br />APPLICATION ACr BY <br />PLANS CHECKED BY <br />I ASUANCE BY <br />FOR IS <br />L DAB <br />ADDRESS FILE <br />