Laserfiche WebLink
.AP�LICATION FOR ���,�, <br />,r.,-�_.,,.;;;��-�; ��NSTRUC�iON � � � P <br />`everett PE RM IT <br />DfPT. Of COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA98201 �COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLJMBI�G PERMIT NO. _ <br />OWNER M��l ADOR[55 CITT ZIP PHONE <br />�C ��rr __��._, �._.... e�. S S��s p8�i� <br />ANCMITECT 00. DESILN(R MAIL AODRF55 C�TY 21P PHONE <br />GENERAtI'ONTRACTOR MAILAUORE55 CITY ZIP PHONE LICEHSFI <br />CITY LIP FNJ`1E <br />PLUMNING CONTR�CTON M�II ApDNE55 CITY ZIP PNONE LICENSF � <br />❑NEW V^^OADDITION ❑AITERATION ❑REPAIR C�DEMOiITION ❑FENCE �SIGN L,GARAGE L7BUILDING RELOCATION <br />V�iUnT10N OF K'OFK <br />��� <br />� DO <br />Ot5CN19E\VOFK ' <br />s�c,,.� f - 7v vc �u� a.0 �alv�i� P2oP�*1 <br />rnoroseo use or nunoi�+c <br />l[WL OESCRIPiION Oi I'FOPERTY (SMO\YN 11[lOW OR nTTA�C/I�I fO/U/N COPIF51 <br />LO1��BlOCK���� v ALY /T�GL. <br />io/nnu/cuess <br />1¢Gi %�� � VFaI G,-'Ls�c <br />PLUMBING <br />Vp, TYPE OF FIXTURE <br />WATEH CLOSET �TOLIETI <br />BATHTU9 _ <br />LAVATORYIWA511 [IASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />OISWASHER <br />UUNDHY TRAY <br />CLOIHCS WASHER <br />WATER HEATEN _ <br />URINAL <br />ORINKING FOUNiAIN <br />FLOOR DRAIN <br />VACUUM I7REAKERS <br />ROOF OHAINS—HAINLEADfHS <br />SINK ($ERVICE—IIAR, ETCJ <br />SUBTOTAL <br />PERMIT <br />iOTAL FEE <br />uno vnun SFTnA[K STREET 5[Tf7ACK <br />USE 70NE <br />7YPE OF CONST. <br />$IZC OF I1LOG. <br />fBC 70N[ <br />�LOTAREA <br />OCCUP4NCY C701/1' <br />NO. GF STORI[5 <br />IfASF.MCNT 1110NOOM5 <br />APPPOVALS <br />1, f N\'IRONM[NTAL CHECK LIST <br />7. OUILOING PLANS <br />7 fIHC HYDRAN7 <br />4. FIRF. 1'ROTCCTION SYSfEM <br />5 GRADING�IXUVAI ION R CLLARING�f.RI IpIPNG <br />6. ORAINAGC <br />' ENVIRONMFNTALIMPACTSTATEM(NT <br />8. HEALTII DISTF.CT <br />FEE <br />�S <br />REnR VAHU 51 <br />VACANT SITE <br />OYES ❑NO <br />NO Of DWEL <br />A7AK. OCC LC <br />flRf. iPRINXL <br />R[QUIHED <br />❑Vf5 ❑NO <br />BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO 8E TRUE AND CORZECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING 1�H15 TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIfIED HEREIN <br />OR NOT. ThIE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE O�� CONSTRUCTION. p ) <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE�D�/ '/ � <br />MECHANIfAL <br />TYPE OF EQL <br />AIN COND. UNIT$—HP. EA <br />REFRIGERATION UNITS—M <br />OOLL[R$—II.P. EA <br />GA$ fIRFD A.C. UNITS—TONNAGE EA <br />PnN[ED nIR SYSTkMS—I4.T.U. N <br />\VALL IICAT6N5—Ii.T.U. <br />UNIT HEATERS—OSL. M <br />IiVnPORATIV[ COOLERS <br />VfNTILAiION FAN <br />HANG[HOOD <br />AIR HANDLING UNIi— CF M. <br />STOVE <br />MFTAI I`IRCPLACk ft CItIhWPY <br />fUACK PLAN CHECK DIUMOE <br />FfES <br />ING UNITS <br />17UILDING <br />1D <br />PLUMIIING <br />RS <br />AIFCHANICAI. <br />DATE OTfIiR <br />PCNALTY <br />T07A1 <br />APVIICATION nit. 17Y PLANS CNfCKED 11Y I APPR. fOR ISSUANCE I4Y <br />4 1-79 <br />SUB TOTAL s <br />PERMIT S <br />iOTAL FEE f <br />PLAN CH[CK FEE <br />FkE RKEIPi NO. <br />VALUATION FEE <br />S <br />u n.c. <br />5[C.703W) <br />� <br />PERMIT VALIDATION <br />Np'HCN PROPERIY VALIUMED UN THIS SPACE) THIS IS YOUR PERMIT <br />rLr,!'v 4��7�1�t� <br />3t u�t.i ?O 8Fs A 4 c. �� <br />�A./ 7�i�2/(l0� �iZGoERiY ¢2 <br />� <br />� <br />