Laserfiche WebLink
rlie E��rrerern <br /> �veret� � ��ONSTRUCTIO � ' <br /> P� RMIT PERMIT NO. �-65ib <br /> CITY HALL 259�8'�4i <br /> EVERE7T,WA9B201 ❑ COMBINATION YC� BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> OWNLF �,1AIL ADOFE55 CIiY LP PMONE <br /> BETTY ERWIN 2112 IAMEARD �verett WA 98201 <br /> ARCMITEGT OR pEdIGNER MAIL AODRE55 CITV ZIP PMONE <br /> GENERAL CONTRACiOR MFIL AO�RE55 CITY 2ip PMONE LCENSE X <br /> MEGHANIGAL CONTRFCTOR MAIL AOORESS CITV ZIP PHOkE LICENSE N <br /> PLUMBING GONTRAGTOR MAIL ADORESS CI7Y ZIP PHONE UCENSE� <br /> CLA55 OF WORR <br /> ❑ NEW ❑ A�DITION ❑ ALTERATION RREPAIR ❑ DEMOLI710N ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLAC :RT <br /> VALUATION OF WOflN <br /> S CS�.�O <br /> �ESCRIOE WORN <br /> Composition reroof <br /> PFOPOSED USE OF BUIL�ING <br /> Single family �esidence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATIUN AND KNOW THE SAME TO BE TRUE �ND <br /> LEGnL OESCRIPTION OF PROPEOTY�SMOW BELOW Ofi ATiACM FOUR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK_OF GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED N.�I"fH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE <br /> OR CANCEL THE PROViSIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTI��THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> IOB AD�RESS SIGNATURE OF CONTRFCT R�OR A HORIZEO AGE DAT� <br /> 2112 Lombard X / � <br /> io< �. <br /> PLUMBING MECHANICAL <br /> NO. TYPF OF FIXTUFE OR ITEM FEE NO.. TYPE OF EQUIPMENT FEE <br /> WA7ERCLOSE7�TOILEn �_ hIR CUND. UNITS — H.P. EA. <br /> �ATHTl10 REPRIGERATION UNITS— H.P. EA. <br /> LAVATORY�WASH BASIN) � 601LER5 — Hp. EA. <br /> SHQWEH GAS FIRED AL.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRY TflAY UNIT NEA7EFS— B.T.U. M <br /> CLOTHES WASHER EVAPORA7IVE COOLERS <br /> WATER HEATER CLOiHES DRYERS <br /> UriINAL VEIJTILATION FAN <br /> DRINKINu FOUNTAIN RANGE HOOD <br /> FLOOP DRA!N AIR HANDLING UIJ�T— QF.M. <br /> VACUUM BREAKERS S70VE —WOOU <br /> ROOF DRAINS— RAINLEADERS METAL rIREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR, ETC.) F:REPLACEINSERT <br /> HEAT PUA1P <br /> SUB TOTAL 5 SUB TO7AL 5 <br /> PERMIT S PEfiM1T S <br /> TO7AL FEE S TOTAL FEE S <br /> SIDE VARD SETBACY. STREET SETBACK REAR VARD SE7BACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RtCEIPT NO. <br /> USE ZONE LOT 4REA VACANT SITE -- <br /> � .YES � �NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROLP N0. UF DWGLLING UNITS <br /> BUILDING i• O ; QQ�� 0�� <br /> S¢E OF BLDG. N0. OF STORIES IAA%. OCC. LOAD I <br /> PLUM6ING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS �i�i <br /> flEf1l11RED MECHANICAL ��` f,l �� <br /> VES ,NO <br /> APPROVALS BY UATE �THER StdtB B1d�J SllI 1��� fi „� 1 50 <br /> 1. ENVIRONMEN'iAL CHECK LIST PENALTY U.B.C. <br /> SEC.303(a) <br /> 2.BUILDING PLAN5 <br /> 3.FIREHYDRANT TOTAL I.�I SO <br /> 4.FIRE PNO7ECTION S1'STEM PERMIT VAL��ATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN 7HIS SPACE)7HIS IS VOUR PERMIT <br /> 6.Df1AINAGE .JI <br /> i "t <br /> 7.ENVIRONMENTALIMPACTS7ATEMENT -�� <br /> i : <br /> 8.HEAL7H DISTRICT • <br /> APPUCATION ACC. BY PLANS CHECKED BY APPR. FOR ISSUANCE BY <br /> AQDkESS f-ILE <br />