Laserfiche WebLink
� CI7Y HALL 259�8745 <br />EVERETT. WP 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWkEP MAILADDRE55 CITY ZIP PMONE <br />y�nrmu 9ltATtyT�`!lA GGf1]^ nn68j,D FVFRFTT WA_ 4890? iSi—I191_ � <br />4RCMiTEGTOPpE51GNER MAILADORE55 pTV 21P FNONE <br />GENERALCONTRACtOR MFILADOP.E55 CIiV ZIP PMONE SIG`_NSEf <br />NECI'ANICALCONTRACTOR lAAILApDFE55 LIIY ZIP PHONE LICENSE/ <br />4FT F <br />GLUMBING CONTqACTOP MAIL AppRE55 CiTY ZIP PNONE LICENSE � <br />C1A55 OF WORK <br />C�NEW <br />VALl1AT10N OF WOPH <br />E <br />DESCRI6E WORK <br />TN <br />PROPOSED USE OF BUILDIA <br />LOT BLOG�OF <br />PLUMBING <br />NO. TYPI <br />VJATER CLOSET Q <br />BATHTU9 <br />LAVA70RY(WASH <br />SHOWER <br />KITCHEN SINK 81 <br />DIShIWASHER <br />IAUNDRY TPAY <br />CLOTHES WASHE! <br />WATER HEATER <br />URINAL <br />DRINKING FOUN7 <br />FLOOR DRAIIJ <br />VACUUM BREAKE <br />ROOF DRAINS -- <br />ciur iccavirc _ <br />SIDE VAPD SETB <br />USE ZONE <br />TYPE OF CONST. <br />SIZE OP BLDG. <br />rr,=_ <br />❑ADDITION ❑ALTERATION ❑REPAIR ❑CEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />I HEREBY CERTIFY THAT I HAVE READ AtJD EXAMINED THIS AP- <br />oeowoannncHFcuRcoPies� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GC'/ERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETF.:R SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI_ THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAiUFE OF CONT VACiOR OF TNO ZED AGENi DATE <br />E . x � �a.�.� <br />MECHANICAL <br />OR ITEM <br />SiREET SETBACK <br />APPHOVALS _ <br />1. ENVIRONMENTAICHECKLIST <br />2. BUILDING PLANS <br />3. FIRE HVDRANT <br />4. FIRE PROTECTION SYSiEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRIGT <br />APPLICATION ACC. BV PLANS CHEGKED BY <br />VC VC <br />FEE <br />REAR YARO SETBACK <br />VACANT SITF. <br />❑YES ❑NO <br />N0. OF DWELLING U� <br />MAX.00G LOAD <br />APPR.FORISSUANCE DY <br />VC <br />FGE <br />AIM I.VrvU. Urvlld — IY.Y. tA. <br />REFRIGERAiION UNITS — H.P. EA <br />BOILERS — H.P.EA. <br />GAS FIFED A.C. UNIiS — TONNAGE FA. <br />FORCGD AIR SYSTEMS — B.T.J. �� <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — O.LLL Id <br />EVAPORATIVE COOLERS <br />RANGEHOOD <br />AIR HANDLING UNIT — QP.M. <br />STOVE <br />ME7AL FIREPLACE 8 CHIMNEY <br />3UBTOTAL <br />PLAN CHEGK FEE <br />FE[ I RECEIPT N0. <br />BUIL�ING S <br />PLUIdBING <br />MECHANICAL % S O <br />OTHER <br />PENALTY U B C. <br />SEC. 303 (a) <br />TOTAL 7 5 C <br />PERMIT VALIDATION <br />WHEN PPOPERLY VALIDATED (M THIS SPACE� THIS IS YOUR PERMIT <br />2323 $(J�].5Q- �j <br />� <br />� <br />, � ('. Cf �PT o <br />. ... �t '_. l� <br />A.DDRE55 FILE �� I � � U �� <br />