Laserfiche WebLink
� �hefvergreen � ��y�TR�JCTION �� <br />CITY OF <br />e�erett PERMIT PERMIT NO.O�OZS <br />CITY HALL 259�874'.; <br />EVERET�, V7A 98201 ❑ COMBINI►TION � BUILDING ❑ MEGHANICAL ❑ PLUMBING <br />�OWNER. � � kA�L�DDR[55 GiTY 7.IP PHONE <br />Naturalizez Wesc ].512 Sout.h 3r.oadway <br />ARGHITECT OR OESIGNER MRiL ADGRE55 CITY ZIP PHONE <br />GENERALCONTRACTOR MAILADDRE55 CITY ZIP PHONE IICENSEI <br />Meyer Sign 1512h Minor Seattle 624-9243 <br />MECNAHICFLCANTPnCTOR MAILAODRE55 CITY ?IP FMONE LICENSF � <br />PLOM9INGCONTRRCiOR MAILADDPESS CIiV ZIP PMONE IICENSE• <br />CLA55OF WORK <br />❑NEW ❑ADDITION ❑AL1EflAilON ❑r7EPl.IR ❑DEMOLiTION ❑FENCE �SIGN ❑GARAGE <br />vnwnnon oF woaK <br />s 500.00 <br />DESGFIBE WUPN <br />er�ct il�uminated sign <br />PROPOSED USE OF BUILOIN3 <br />LEWL 0[SCRIPIION OF PRCPEFTV �SMOW BELOW OR FTTPLH FOUR COPIE51 <br />LOi BLOC�_OF . <br />JOB ADORESS <br />____ �outh Broadway <br />PLUMBING <br />N0. TYP[ OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILET) <br />�ATHTUB <br />LAVATORY (WASH F7ASINJ <br />SHOWER <br />KIiCHEN SINK 5 DISP. <br />DIEMWASHER <br />iAUNDFYiRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAi <br />ORINKING FGUNTAIPI <br />FLOOR DAAIN _ _ <br />ROOF <br />— BAF,, <br />SIDE YARD SEIOACK STREET SETBACK <br />u5E ZONE LOT AF1EA <br />REAR YARD SET�A' <br />VACAN'i SITE <br />❑YES ❑NO <br />NO.OF DWELLING <br />MA%.00G LOAD <br />FIRE ZONE �ASEMENT FIRE SPRINKL <br />REOUIRED <br />CIYES ❑NO <br />APPHOVALS BY Di <br />1. ENVIRONA1ENiAL CHECK LIST <br />2. BUILDING PLANS <br />3, FIRE HYORANT <br />4 FlR[ PROTECTION SYSTEM <br />5. GRA�ING <br />s. oaninnce <br />L ENVIRONMENTALIMPACTSTPTEMENT <br />8. HEALiH �1STFiIGT <br />APPLI�ATION ACC FY PU+NS CHECKED BY l+PPR FOR !SSUANCh BY <br />BAB <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND iCNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THiS <br />TYPE OF WORK WIL� 8E COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANC[L THE PRO• <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRU TION OR TlH�ERFORMANCE OF CONSTRU�TIOM. <br />SICNATUHE F ONTRACiOR Gp 4UyF+OR �=GENT DAtE <br />/ ! {r <br />i� .4'l�"� `�'- <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.fl EA. <br />PEFRIGEFATION UNITS — H.P. EA <br />BOILERS — H.P. EA. <br />GAS FlRED A.C. UNITS — TONNAGE E1. <br />FORCED AIR SYSTEMS — B:i U. M <br />WALL HEATERS — B T.LL �A <br />UNIT HEATERS — B:LU. M <br />[VAPORATNECOOLERS <br />AIR HANOLING UNIT — CF.M. <br />STOVE <br />MFTAL FIHFPLACE 6 CHIMNEY <br />Fer <br />TOTAL FEE 5� I <br />PLAN CHECK NUM9ER PLAN CHECK FEE <br />FEE F�ECEIPT NO. <br />FEES VALUATIfiN FEE <br />BUILDING $ SQQ. 5 �� <br />PLUMBING <br />MECHANICAL <br />PeNALTY <br />TOTAI. <br />U.B.C. <br />SEC. 303 (a) <br />� � 1 <br />WHEN PFOPERL" VPLI�ATED 1IN THIS SPA�CE�TI I; IS VO�REf�1,yT. a O ..���� <br />J ( � U 1 <br />N <br />O <br />Y(n�J t; REC.EIPbo <br />�;[ANK YOU� <br />) � .i�7. $� <br />