Laserfiche WebLink
the Evergreen <br />CITY OF <br />Ai AICATION FOR <br />CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />5 <br />CITY HALL 259-874 <br />EVERETT. WA9B2B1 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNIR MAR ADDRESS CITY LIP LIP PHONE <br />A <br />OR <br />MAIL ADDRt 55 <br />CITY ZIP <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />City <br />ZIP <br />PHONE <br />LICENSE E <br />.MECHANICAL CONTRACTOR <br />/V/vo i/JY <br />/\� MAIL ADDRF 55 <br />J f�[2s <br />�Z�2. <br />CITY <br />Mtc�cr <br />LIP <br />'7:910% <br />PHONE <br />1c1�/_g2Jt3 <br />LICENSE R <br />ff04(G� <br />PIPAIRINI: CON ACTOR MAIL ADDRESS Serf �L �. CI,♦ ... ..._._ <br />Cl ASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE SI�IN ❑GARAGE ❑BUILDING RELOCATION <br />kal AIION Of WORK <br />5 f!' <br />OF It RULE WORK <br />PROPOSED ILSE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE 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 CONTRACTTn/OR OR AUTHORIZED AGENT DATE <br />IFGAL DESCRIPTION OF PROPIRIY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK —Of <br />ot, <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOLIEI) <br />AIR COND UNITS -HP EA <br />BATHTUB <br />REFRIGERATION UNITS -HP EA <br />IAVATORY OVASH BASIN) <br />1301LERS-H P EA <br />SHOWER <br />GAS FIRED A C UNITS -TONNAGE EA <br />KI7CHEN SINK R DISP <br />FORCE D AIR SYSTEMS-B T U M EA <br />OISWASHER <br />WALL Hf ATERS-BTU M <br />LAUNDRY TRAY <br />UNIT Hf ATF RS-BTU 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 />S10VE <br />ROOF DRAINS -RAINLE ALL ITS <br />MFTAI. FIREPLACE A CHIMNEY <br />SINK (SERVICE -OAR. ETC 1 <br />SUB TOTAL S <br />SUBTOTAL <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />TOTAL FEE i <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />' <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />(7YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY CROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />IODROOMS <br />FIRE SRfINKLE95REQU <br />nYIS rlNO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U BC <br />SEC 303(e) <br />2 BUILDING PLANS <br />TOTAL <br />7 FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />^ <br />`7 <br />71'a/ko <br />5 GRADINGE XCAVAT ION& CU AR INGIGRU BEING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC By <br />PLANS CHECKED BY <br />f ISSU 'Ck <br />91 79 <br />