Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 B745 <br />EVERETT, WA 98201 <br />INSTRUCTION <br />PERMIT <br />COMBINATION *BUILDING • MECHANICAL <br />ft <br />PLUMBING <br />�e <br />evere" <br />OWNER MAIL ADDRESS .'li' PHONE <br />JK Gill 1512 So Broadway Everett, WA <br />m <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />i <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />7 <br />f' <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE I O. <br />Simco Sign Inc SI MC OS 8� y <br />w <br />Csl m <br />m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />QD <br />PERMIT CLASS <br />❑COMBINATION <br />❑BUILDING ❑PLUMBING ❑MECHANICAL <br />OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />(T) <br />VALUATION OF WORK <br />S 900.00 <br />❑DEMOLISH ❑FENCE SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />Put up sign <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />FOUR <br />LOT BLOCK —OF <br />ND. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS—H.P. EA. <br />$ I <br />REFRIGERATION UNITS—H.P. EA. <br />BOILERS—H.P, EA. <br />I <br />FORCED AIR SYSTEMS—B.T.U. MEA. <br />I <br />JOB ADDRESS <br />1512 So Broadway <br />SPACE & WALL HEATERS — B.T.U. <br />UNIT HEATERS—B.T.U. <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />fl ANG E}IOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT— C.F.M. <br />BATH TUBS <br />S <br />1 <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS <br />FLOOR DRAINS <br />I <br />SUBTOTAL $ <br />I <br />KITCHEN SINKS & DISP. <br />I <br />PERMIT S <br />TOTAL FEE S I <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTERWORK ISCOMMENCED. <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 />I <br />5-2-79 <br />(�(./ <br />BAR SINKS <br />ROOF DRAINS — RAIN LEADERS <br />SHOWER BATHS <br />SERVICE SINKS <br />SUMPS —SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />I <br />WATER HEATERS — ELECTRIC <br />I <br />WASH BASINS <br />1 <br />LAUNDRY TRAYS <br />I <br />I <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SIGNATURE OF CONTRACTOR OR AUTH.AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNIOSF DWELLING <br />I <br />BUILDING <br />S 900.00 <br />6 100 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />rFEQUIREDSPRINKLERS <br />YES ONO <br />MECHANICAL <br />OTHER <br />1 <br />SPECI,CL CONDITIONS: <br />I <br />I <br />PENALTY <br />SEC. 700 (a) <br />I <br />1 <br />- - -_ -- _ <br />- -- <br />TOTAL <br />I <br />0 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />�(dU R 4ECEA7 <br />,THANK YCfo <br />i , 1 <br />--. 704ncUP1111 Ely : <br />PLANS CHECKED aY: <br />APPROVEDFORMLIANCEDY. <br />RESS FILE <br />