Laserfiche WebLink
I <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 <br />CONSTRUCTIO" <br />PERMIT <br />❑ COMBINATION Xfl BUILDING ❑ MECHANICAL <br />IDERNIM NO. 13850 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CIT" ZIP PHONE <br />- -- <br />mni1 <br />CIT) <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />TUBELAoN <br />PO Box C19013 <br />a 1 WA as <br />0420 <br />PHONE LICENSE, <br />RDIoPLAYS <br />MEEICMAIL <br />ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE N <br />PLUMBING CONTpACTOfl <br />MAIL ADDRESS <br />CITY <br />21P <br />r <br />PHONE LICENSE, <br />CLASS OF WORK <br />�IEW ❑ ADDITION <br />❑ ALTERATION ❑ REPAIR <br />❑ DEMOLITION ❑ FENCE <br />❑ SIGN <br />❑ <br />VALUATION OF WORN <br />WOOD STOVE/FIREPLACE INSERT <br />$12.000.00 <br />I nstall nnla Ginn <br />PROPOSED'JSE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LOT —BLOCK —OF <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 VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFO MANCE O TRUCTION. <br />JOB ADDRESS <br />811 SE Everett Mall WayX <br />SIGNA OF CONTRA OR0 THORIZED AGENT DATE <br />_u� 9 3 84 <br />PLUMBING <br />MECHANIC <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET(TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />_ <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />— <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. 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 />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL S <br />SUB TOTAL S <br />PERMIT f <br />PERMIT & <br />TOTAL FEE <br />S <br />TOTAL <br />FEE <br />S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />FEE <br />RECEIPT I40. <br />USE 2014E <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />❑YES ONO <br />TYPE OF CONRT. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S 12,000. <br />39 <br />00 <br />SIZE OF BLDG, <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />-- <br />REQUIRED <br />MECHANICAL <br />❑YES ❑NO <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />39 <br />OO <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS ))tYSUI P671T — <br />UU U U 00 <br />m <br />l ;{ RL'C r I FT � <br />B. DRAI5. NAGE <br />7.ENVIRONMENTALIMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />rf <br />nV <br />"Y,i:K Y, u <br />J <br />I <br />a <br />ADDRESS FILE <br />Ic— <br />- 4 SLP o 4 <br />JI <br />