Laserfiche WebLink
APPLICATION FOR !Y <br />TEYRTBE»^ IAMI <br />CITY OF CONSTRUCTIO( _ <br />CI <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA9B201 []COMBINATION ❑ BUILDING ❑MECHANICAL 19PLUMBING PERMIT NO. <br />�) LADOM ss <br />OWySR 11 <br />MAIL ADDRESS <br />CITY ZIP rNONL <br />ARCN17 .,t OR DESIGNER <br />���97�iQ MAIL ADDRESS <br />CITY ZIP PHONE LICENSE f <br />CE RAL CONTRACTOR <br />-i-��r V CITY CIP PMOHI l CL -- <br />MICHANIUICOMRACION MAIL AODRI55 <br />e..nu. llC[HS[ f <br />PIUMpING CONTRACTOR MAIL ADDRESS <br />CUSS OF WORK <br />DREPA.IR ❑UEMOLITION ❑FENCE ❑SIGN ❑GARAGE OBUILDING RELOCATION <br />❑NEW ❑ADDITION ❑ALTERATION <br />VALUA110N OI WORK <br />S <br />DESCRIBE WORK <br />CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />Paorovo USE OF BUILDING1 <br />PROPOSE <br />HEREBY <br />AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />DESCRIPTION OF PROPERTY SHOWN BELOW OR ATTACH POURCOPILSI <br />PROVISIONS <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />LEGAL <br />THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT __BlocK __or <br />OR NOT. <br />TO VIOLATE OR CANCEL THE PROVISIONS OF <br />GIVE AUTHORITY <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />r <br />ANY OTHER <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT DATE <br />LOB AODR[5560 <br />7� er YQ <br />MECHANICAL <br />PLUMBING <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />AIR CONO UNITS -HP EA <br />WATER ILOSET ITOLIFTI <br />REFRIOERAIION UNITS -HP EA <br />BATHTUB _ <br />BOILERS -HP EA <br />LAVATORY (WASH BASIN) <br />GAS FIRED AC UNITS -TONNAGE FA <br />SHOWER <br />FORCED AIR SYSTEMS-B T U M EA <br />K 1(CHEN SINK 6 OISP <br />WALL HEATERS-B T U M <br />OISWASHER <br />UNIT NEA(FRS-NTU M <br />LAUNDRY FRAY <br />EVAPORATIVE COVLF RS <br />CLOTHES WASHER <br />CLOTHES DRY[RS <br />WATER HEATER <br />VENTILATION FAN <br />URINAL <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT - C f M <br />f1000. DRAIN <br />STOVE <br />VACUUM BREAKERS <br />METAL FIREPLACE 6 CHIMNEY <br />ROOF DRAINS -RAINLEATERS <br />SINK (SERVICE -BAR. ETC) <br />I <br />SUB TOTAL <br />5 <br />SUB TOTAL <br />PERMIT <br />IF <br />PERMIT <br />TOTAL FEE <br />5 <br />TOTAL FIE <br />IF <br />RUR <br />YARD SE TRACK <br />PLANCHECK <br />PLAN CHECK NUMBF0. <br />FEE <br />SIDE YARD <br />SE TRACK <br />STREET SETBACK <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />fitf <br />VALUATION <br />FEE <br />CYFS CNO <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />5 <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PI UMBINL <br />f IRE ZONE <br />BASEMENT <br />BE )ROOMS <br />SPRIN <br />REQUIREDKLERS <br />MICHANICAL <br />t-IVES Cho <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />UBC <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SEC 103(RI <br />2 BUILDING PLANS <br />TOTAL <br />T FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERL' VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT <br />5 GRADINGIEXCAVATION 6 CLE SRINOIGRUBBING <br />6 DRAINAGE <br />7. ENVIRONMENTAL IMPACT STAIEMENI <br />5 HEALTH DISTRICT <br />♦PPE ICATInN ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUAN181 <br />9.1.79 <br />