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5028 EVERGREEN WAY 2016-01-01 MF Import
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5028 EVERGREEN WAY 2016-01-01 MF Import
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Last modified
2/9/2017 6:50:48 PM
Creation date
2/9/2017 6:50:36 PM
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Address Document
Street Name
EVERGREEN WAY
Street Number
5028
Imported From Microfiche
Yes
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� <br /> d�P Et•ergrePn �"- C 0 N ST R U C T I ✓ � <br /> CITV Op I � " ' <br /> everet� PERMIT PFiiMIT NO. 1�503 <br /> r CITY HALL 253�8745 <br /> EVERETT,WA 98201 ❑ COM9INATION Cj� BUILDING ❑ MECHANICAL C� PLUMBING <br /> O�YNEF MAILADDRE55 piY ZiP PMONE <br /> 98203 258-3092 <br /> AqGHI ESi AIL _ ��— ZIP PHONE <br /> GENERAI CONTR/•CTOR MA4.:.:^RE55 CITY ZIP PMONE LICENSE/ <br /> Same <br /> MECHANILAL CONiFACTOR MAIL ADDRESS f.ITY ZIP PHONE LICENSE Y <br /> PLUMBING GONTflAGTOP MAIL AO�flESS GTY Zlp pMONE UCENSE� <br /> CLA55 OF WORK <br /> O NEW ❑ ADOITION ❑ ALTEFATION ❑REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVFJFIREPLACE INSER' <br /> VALUATION OF WORN <br /> S <br /> DESCRIBE WORR <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS o <br /> APPLICATION hND KNOW THE SAME TO BE TRUE AND "i <br /> IEGAL0E5CRIPTIONOFPROPEFTY�SMOYlBELOWORATfACMFOURCOPIESi CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES n <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH �' <br /> :OT_BLOCK_OP � <br /> WHETHER SPECIFIED HEREIN OH NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE � T <br /> OR CANCGL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL !AW REGULATING CONSTRUCTION OR THE "" "i <br /> PERFO ANCE OF NSTR CTION. <br /> `" m <br /> JOB AUORE55 SIGNA7U F C NTR � OR AUTHO EO AGENT DATE <br /> 5028 Evergreen Way X Z 9/30/85 m � <br /> -� c <br /> PLUM8ING MECHANI AL � m <br /> NO TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE _ -ZI <br /> m <br /> WATERCLOSET�TOILEn .11R COND.UNITS— H.P. EA. � <br /> BA7HTUB REFRIGERATION UNITS— H.P. EA. n � <br /> IAVATORV�WA£li BASIN) BOILERS— H.P. EA. t— S <br /> .-� i--i <br /> SHOWF., GAS FIRED A.C.UNI75—TONNAGE EA. —I N <br /> K <br /> t:iTCHEN SINK 8 DISP. FORCED AIF SYSTEMS— B.T.U. M EA. TI <br /> — — O .v <br /> DISHWASHER WAIL HEATERS— B.T.U. M �7 Y <br /> __.—__' — 3 <br /> LAUNDRY"iRAY UNIT HEATERS— B.7.U. M —1 m <br /> 2 <br /> CLO7HES WASHER EVAPORATIVE COOLERS m �+ <br /> _ � <br /> WATER HEATER CLOTHES DRVERS O <br /> - or <br /> URINAL VENTILATION FAN C N <br /> DRINKING FOUNTAIN RANGE HOOD 3 fn <br /> m <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. = C� <br /> VACUUM BREAKEPS STOVE—WOOD � frT1 <br /> A <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CHIMNEY A <br /> j SINNISERVICE— BAR, ETC.) 2 00 FIFEPLACEINSERT = <br /> HEAT PUldP Z <br /> -� <br /> x <br /> N <br /> SUB TOTAL S SUB TOTAL S _ � <br /> P°RMIT S 3 p PERMIT S --� <br /> �-. <br /> TOTAL F�?'e S TOTAL FEE S n <br /> m <br /> SIDE YARD SETBACK STREET SE78ACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> "EE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE I � <br /> II .YES ;iNO FEES VAWATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP ��NO. OF DWELLING UNI75 <br /> BUILDING 5 <br /> SI2E OF BLDG. NO.OF STORIES MAX.OCC. LOAD <br /> PLUMBING S OO <br /> FIREZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> [�YES :_:NO <br /> APPROVALS BY OATE aTHER <br /> 1.ENVIRONMENTAL CHECK LIST pENALTV �.B.C. <br /> 2.BUILDING PLANS SEC.303(a) <br /> 3.FIREHY�RANT TO7AL S 00 <br /> 4.FIRE PROTECTION SYSTEM PEHMIT VALIDATION <br /> � 5.GRADING WHEN PROPERLY VALIDATED QN TFyS'�!AQE)THI�I$VOOUR PER�MIT � <br /> B.DRAINAGE � 6 � 5 C <br /> ,, , <br /> 7.ENVIfiONMENTALIMPACTSTATEMENT �;�� <br /> 8.HEALTH DIS7FiICT <br /> APPLICATION ACC. BY PLANS CHECKED BY APPP. FOR ISSUANCE BY � �`, �� I� P.[C 61 PT ` � <br /> i ;-!�';NK YOU <br /> t�oor<ess Fi�e <br /> Z9SEPb5 <br />
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