Laserfiche WebLink
. <br />the EvergreerF <br />APPLICATION F Q -` <br />"'' "' <br />CONSTRUCTION <br />everett <br />everett <br />DEPT. <br />MIT <br />OF COMMUNITY DEVELOPMENT <br />SERVICES <br />- CITY HALL 259.8745 <br />EVERETT, WA 98201 COMBINATION ,�/ <br />❑ BUILDING <br />ON'Nf R <br />LIMECHANIGAL ❑PLUMBING <br />PERMIT NO. <br />�llri?i=T <br />FL.DWi-mac <br />MAIL ADDRESS CITY ZIP <br />_ <br />1'NONE <br />, ARCHNECT <br />OR DESIGNER <br />��i5 z2 ���1/��=err fr 5 oo <br />MAIL ADD0.E35 <br />Z '�r�s� <br />CITY ZIP <br />PHONE <br />GENERAL [ONTRAC70R <br />MAIL ADDRESS CITY <br />MECHANICAL CO\TRACTOR <br />ZIP <br />/�D in CfL�/l /q C <br />- <br />PHONE LICENSE 0 <br />L o (� <br />MAIL ADDRESS "�oU� <br />CITY <br />.�t )rl-9cee) <br />ZIP <br />PHONL ICENSE p <br />rwA+Innc coNrRAcioR <br />...,, ....... ST: 2�-3-OZ -cS /r'AleT .s'2e��- OA <br />-•- <br />ZIP PHONE <br />LLASS OF WORK ❑�,., NEW ❑ADDITION ❑ALTERATION ❑REP,AIR ❑DEMOLITION ❑FENCE (!?SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />�/l Ft�% 2TY QY Tr ie e, nn_ <br />PROPOSED USE OF BUILDING <br />c5/ <br />- C / Pkolw7eF A <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAMELEGALDESCRIPTIONOFPROPERTY(SHOWN <br />PROVISIONS OF LAWS AND ORDINAONCES GOVERNING THIS TYPE <br />OF WORK WILL RE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE 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 OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />MECHANICAL <br />BELOW OR ATTACH FOUR COPIES) <br />LOT //) BLOCKOF__ <br />LOB ADDRESS <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE <br />WATER CLOSET (TOILET) <br />13ATHTUB <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />AIR COND. UNITS—H.P. EA <br />R RIGERATION UNITS—H.P. EA <br />FEE <br />VATORY(WASH BASIN) <br />BOIL S—H.P, EA <br />S1 WER <br />GAS FIR. A.C. UNITS —TONNAGE FA <br />KITCH SINK & DISP. <br />FORCED AI YSTEMS—B.T.U. <br />DISWASH <br />WALL HEATER B.T.II. M <br />LAUNDRY TRA <br />UNIT HEATERS— U. A+ <br />CLOTHES WASHE <br />WATER HEATER <br />EVAPORATIVE COOL S <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACE & CHIMNES' <br />SINK (SERVICE —BAR, ETC.) <br />SUB TOTAL <br />SUBTOTAL b <br />PERMIT S <br />PERMIT $ <br />� <br />TOTAL FEE S <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />b <br />SIZE OF BLDG.NO. <br />OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />BEDROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />DYES ❑NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC. <br />SEC. 303(a) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />5. GRAOINCIEXCAVAT ION & CLEARINGICRUBBING,, <br />8. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED OY <br />t A <br />APPH. F Sl NC BY <br />91 J9 <br />