Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />CCASTRUCTION <br />PERMIT <br />❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />GRAft <br />PERMIT NO. 07751 <br />❑ PLUMBING <br />OWNER <br />MAIL ADDR1,55 <br />CITY <br />ZIP <br />PHONE <br />GeOrgs H. MaoTrudee <br />6321 Beverly lvd piraret <br />PIA201 <br />ASa-RR17 <br />ARCNRECT OR DESIGNED <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS GTY ZIP PHONE LICENSE E <br />C an above <br />MECHANICAL. CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK ❑(''L�NEW ❑ADDITION yL.LTERATION ❑REPAIR ❑DEMOLITION El FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />i •^^^ nn <br />DESCRIBE WORK <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGALDE IPTIONOFPROPERTY(SHOWBELOWORATTACHFOURCOPIES) <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT BLGCK_OF <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />10 <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />Tract 1. North Beverly Park Val <br />of Plat <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />Page 26 <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />JOB ADDRESS <br />6321 Beverly Blvd. <br />X -1B-BO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. I <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TO LET) <br />I <br />nn <br />I AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY ASH BASIN) <br />BOILERS — H.P. EA <br />1 <br />SHOWER <br />2 <br />00 <br />GAS FIRED AC. UNITS — TONNAGE EA. <br />1 <br />KITCHEN SINK 8 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 />WATER HEATER <br />2 <br />00 <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 DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUBTOTALDO <br />SUBTOTAL i <br />PERMIT <br />$ <br />3 <br />100 <br />PERMIT i <br />TOTAL FEE <br />S <br />TOTAL FEE i <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 />7751 <br />14.00 <br />49089 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />N0. OF DWELLING UNITS <br />V-N <br />(_; Lg <br />BUILDING <br />'4000.00 <br />28 <br />00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />— <br />16x19 <br />1 <br />PLUMBING <br />11 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL <br />2 <br />OYES ONO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303(a) <br />2. BUILDING PLANS <br />TOTAL <br />39 <br />00 <br />3. FIRE HYDRANT w <br />4. FIRE PROTECTION SYSjF,A <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />L1�r <br />3627 $028.00 <br />5. GRADING ..< v <br />6. DRAI E <br />y <br />I� <br />r <br />C <br />YOUR RECEIPT <br />�7 ENVIR�M�AL IMPAZ'ISTATEMENTIMPAZ'ISTATEMENT <br />HEALT(�' (STRICT <br />BY <br />APPLICA O . BYAPPLICA O BY�LANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />APPR, FOR ISSUANCE BVCHECKED <br />o V.C. <br />THANK YOU <br />m <br />