Laserfiche WebLink
r <br />the Evergreen <br />CITY OF <br />^.ONSTRUCTION <br />everett <br />PERMIT <br />CITY HALL 259 8745 <br />PERMIT N0. <br />10597 <br />EVERETT. WA 98201 <br />❑ COMBINATION Kk BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />OWNER <br />Robert J. <br />MAIL ADDRESS <br />Moore 4121 Federal DITY <br />°P <br />PHONE <br />�. ARCHITECT OR DESIGNER <br />Everett <br />98?01 <br />259-2569 <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />------------ <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />Same <br />ZIP <br />PHONE LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ApORE55 CITY <br />ZIP <br />PHONE LICENSE r <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE 1 <br />I.. <br />I, <br />❑NEW KADDITION ❑ALTERATION ❑REPA.R ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />VALUATION OF WORK <br />S 9,000.00 <br />DESCRIBE WORK <br />Addition to exi cT-; .. ;a.,__,. <br />PROPOSED USE OF 'WILLING <br />single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />LEGAL DESCRIPTIONOFPROPERTY (SHOW BELOWORATTACH FOUR COPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />7 3JX <br />LOT -BLOCK -OF Swal lwell l IS 3rd ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPEmF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TG VIOLATE OR CANCEL THE PRO. <br />VISIGNS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTTIION OR THE PERFORMANCE OF CONSTRUCTION. <br />JOB ADDRESS SIGNATUR C TR OR 7HORIZED AGENT DFTE <br />4121 <br />Federal X 0///« i 7 <br />` <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE NO. <br />TYPE OF EQUIPMENT <br />WATER CLOSET (TOILET) FEE <br />BATHTUB AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />DISHWASHER <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />LAUNDRY TRAY <br />WALL HEATERS — B.T.U. M <br />CLOTHES WASHER <br />UNIT HEATERS — B.T.U. M <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 <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE & CHIMNEY <br />SUBTOTAL <br />SUBTOTAL s <br />PERMIT $ <br />TOTAL FEE $ <br />PERMIT $ <br />SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK <br />51 <br />TOTAL FEE $ <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />201 201 <br />8 2 /10 5 9 7 FEE 4 8 . 4 3 RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />R-1 <br />VACANT SITE <br />❑YES <br />57857 <br />FEES <br />VALUATION <br />FEE <br />R�LO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF pWELLING UNITS <br />V-N <br />R-3 Addition <br />BUILDING <br />b 1 000. <br />74 <br />50 <br />SIZE OF BLDG. <br />N0. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />REQUIRED <br />❑YES WNo <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />3. FIRE HYDRANT <br />TOTAL <br />74 <br />S O <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />3 5 0 1 $ 0 7 q. 5 0 -- dp <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />Ln <br />B. HEALTH DISTRICT <br />0 <br />YOUR � E C E I PT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />EB HWM <br />LC <br />I! 1{ NN" YOU <br />ADDRESS FILE <br />-8im82 <br />