Laserfiche WebLink
the Evergreen CITY OF C INSTRUCTION <br />' everett PERMIT PERMIT NO. 19659 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING 9:1 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Harmon and Assoc. 1203 SE Everett Mall Way Everett, WA 98204 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE, <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />3411 Hayes <br />CITY <br />Everett, WA 98201 <br />ZIP <br />252-3114 <br />PHONE LICENSE <br />EVERGSS302DB <br />Evergreen St. <br />Sheet Metal <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />❑ NEW ❑ ADDITION <br />VALUATION OF WORK <br />{E] ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />4 ton gas/elec. <br />HEAT SOURCE <br />F'1 ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />T<etail <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 PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE FCONTRACT R. AUTHORIZED AGENT. OR OWNER DATE <br />X <br />LEGAL DESCRIF FION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />WRPTO 1A PP1111111 <br />JOB ADDRESS <br />1203 SE Everett Mall Way <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 />A/C - A/HNOLG UNITS - H.P. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY ( WASH BASIN) <br />BOILERS - B.T.0 /H.R <br />SHOWER <br />GAS FIRED A . UNITS - R T.U. <br />q <br />on <br />KITCHEN SINK E DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA, <br />DIS'IWASHER <br />WALL HEATERS-B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHESDRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR, ETC.) <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />• <br />rn <br />SUB TOTAL <br />$ <br />SUBTOTAL <br />i F <br />�— PERMIT <br />$ <br />PERMIT <br />Inn <br />TOTALFEE <br />S <br />TOTALFEE <br />FRONT SETBACK <br />REAR SETBACK SIDE <br />SETBACK <br />PLAN CHECK NUMBER <br />RECEIPT IJOUSEZONE <br />LOT AREA <br />VACANT SITE❑YES ❑NoFEES <br />UATION <br />FEE <br />BUILDINGPLUMBINGSIZE <br />FF.EE <br />TYPE OF CONST. <br />OCCUPANCYGROUP <br />NO OF DWELLING UNITS <br />OF BLDG <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />MECHANICAL <br />- <br />30 <br />50 <br />FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO <br />INVESTIGATION FEE <br />Sec. 304(e) <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />S.H. <br />PLANS CHECKED BY <br />— <br />APPR. FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />30 <br />50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN TI4IS SPACE) THIS IS YOUR PERMIT O <br />L-0 <br />C-0 <br />CM <br />t— <br />ADDRESS FILE <br />