Laserfiche WebLink
APPLICATION FOR-, <br />�T YOF ° ;ONSTRUCTION <br />everett PERMIT <br />DFPT OF COMMUNITY DEVELCIMF.NT SERVICES <br />CITY HALL 259.874S <br />EVERETT, WA98201 EICOMBINATION ❑BUILDING ❑MECIHANICAL ❑PLUMBING PERMIT NO. <br />a <br />ZIP <br />GENERAL CONiRAC I OR MAIL ADDII CITY IP PHONE LICENSE# <br />/7471 //-c— <br />.CHAMCAL CONTRACTOR MAIL ADDRESS CITY CIP PHVRL UAcmr,• <br />PLUMPING CONTRACTOR MAIL ADDRESS CIl1 ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELGCATION <br />VALUAI1ON Of WORK <br />F /i/ 7 ! flao 7L5E1 _ <br />De>culnE WoaK <br />YLRDPDSIDUSE OF nuaowc I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE.AND CGI:a <br />`F'T 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 />S IG NATUR OF CONTRACTOROR AUTHORIZED AGENT Y DATE <br />x / Y <br />LEGAL DESCRIPTION Of PROPERTY (SHOWN BFICIV OR ATTACH FOUR COPIES) <br />LOT _ BLOCK —Of <br />1011 ADDRESS <br />i�af /�AAgA OC-.i9- <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. I <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOLIETI <br />AIR COND. UNITS—H P. EA <br />BATHTUB <br />REFRIGERATION UNITS—H.P EA <br />LAVATORY (WASH BASIN) <br />BOILERS—H P EA <br />SHOWER <br />GAS FIREDAC UNITS—TONNACE EA <br />KITCHEN SINK b D15P <br />FORCED AIR SYSTEMS-0 I M EA <br />DISWASHER <br />WALL HEATERS—B T.U. M <br />LAUNDRY TF. AY <br />UNIT HEATERS—B T U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER IIEAFER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRIN ANG FOUNTAIN <br />RANGE HOOD _ <br />FLOOR DRAIN <br />A,R HANDLING UNIT— C F M <br />VACUUM BREAKF ITS <br />STOVE <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK(SERVICE—BAR. ETC) <br />SUBTOTAL <br />SUBTOTAL S <br />_ <br />PERMIT <br />f <br />PERMIT S <br />IOTALTEE <br />S <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES DNO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />IHDROOMS <br />FIRE SPRINKLERS <br />ENKLERSREQ <br />❑YES ONCE <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL .:HECK LIST <br />PENALTY <br />U.BC. <br />$EC. 303(a) <br />2 BUILDING PLANS <br />TOTAL <br />FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IN THIS SPACE) TH1515 YOUR PERMIT <br />GRADINGILXCAVATIONACIEARINGIGRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />8 HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />_-j <br />9-1-79 <br />