Laserfiche WebLink
the Evergreen <br />CITY Oi <br />everett <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 <br />(:ONSTRUCTIOV- <br />PERMIT <br />❑ COMBINATION )ffl BUILDING ❑ MECHANICAL <br />PERMIT NO. 16299 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />R. R. PIERRE 8016 BEVERLY BLVD EVERETT WA 98203 (206) 353-2980 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL 40DRESS CITY ZIP PHONE LICENSE <br />SkiE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CIIY ZIP PHONE LICENSE# <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />V'^VV ❑ NEW Cl ADDITION ❑ ALTERATION ❑ REPAIR W DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />f <br />Demolition of Garaoe <br />P50POSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANC MFONS UCTION. <br />SIGNATURE OF RIZED AGENT DATE <br />x� <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />LOT 26 BLOCK 5 OF -Beverly Park <br />JOB ADDRESS <br />8016 Beverly Blvd <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. 'A. <br />LAVATORY(WASH BASIN) <br />BOILERS — H.P. EA. <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 />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 — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />S <br />SUB TOTAL $ <br />PERMIT <br />f <br />PERMIT S <br />TOTAL FEE <br />$ <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES :NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />N0. OF DWELLING UNITS <br />BUILDING <br />$ <br />00 <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 />YES NO <br />MECHANICAL <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />_ <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />00100 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED RN THIS S,'gpEt 11HI5 IS "TMI PORTo _ C" <br />[[ // I li BUJ ll�� <br />(l <br />. ' <br />II <br />B. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />&.HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />