Laserfiche WebLink
the CITY <br />CONSTRUOCTIOn E everen <br />CITY OF <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT 5ERVIC -1 <br />CITY HALL 259-8745 <br />EVERETT. WA90201 ❑COMBINATION LJ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />OWNER ��J MAIL ADDRESS CITY ZIP PNONE <br />3 Y <br />I,//e-4/"c/ 7 �___ // Fries; c>/ 9(�.za <br />GENERAL CONTRACTOR <br />MAIL <br />ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE IF <br />SG/T /' <br />MECHANICAL CONTRACTOR <br />MAIL <br />ADDRESS <br />CITY <br />LIP <br />PHONE <br />ll[ENSfF <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICEY.S! <br />:LASS OF WORK <br />❑NEW ❑ADDITION ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />S -'c00 <br />DESCRIBE WORK <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PROPOSED USE OF aUILDING <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />LEGAL DESCRIPTION Of PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />/ �I. A•7C/, <br />6 BLOCK_OF 6T"_ �fci j <br />OF <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULI.TING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X !� <br />LOB nODakss <br />O \l <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOLIET) <br />AIR CONE) UNITS—H P. EA <br />REFRIGERATION UNITS—H. P. EA <br />BATHTUB <br />BOILERS —HP EA <br />LAVATORY (WASH BASIN) <br />SHOWER <br />GAS FIRED A UNITS —TONNAGE EA <br />FORCED AIR SYSTEMS—B T.U. M EA <br />KITCHEN SINK 8 DISP <br />WALL HEATERS—B T. U. M <br />DISWASHER <br />UNIT HEATERS —BTU M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOT TIES WASHER <br />CLOTHES DRYERS <br />, <br />WATER HEATER <br />VENTILATION FAN <br />URINAL <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />AIR HANDLING UNIT— C F M. <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS —RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE —BAR. ETC) <br />SUB TOTAL S <br />SUBTOTAL <br />PERMIT S <br />PERMIT <br />S! <br />TOTAL FEE S <br />TOTAL FEF <br />S <br />SIDE YARD SETBACK <br />STREET SETBACK REAR <br />YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE 3 <br />CHECK FEE <br />RECEIPT—NO.6 <br />r <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />` 3 <br />OYES ONO <br />TYPE OF CONST <br />OCCUPANCY GROUP NO <br />OF DWELLING UNITS <br />BUILDING <br />S <br />10 <br />SIZE OF BLDO. <br />NO. OF STORIES <br />MAX OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASF MENT <br />IIk GROOMS <br />SPRINKLERS <br />REQUIREFIRE D <br />MECHANICAL <br />YEs ONO <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC. <br />. <br />SEC303(a) <br />2. BUILDING PLANS <br />TOTAL <br />J FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />5 GRADINGIE XCAVATION B CLEARINGIGRUBBING <br />6 DRAINAGE <br />7, ENVIRONMENTAL IMPACT STATEMENT <br />8, HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />�T7� <br />GAF <br />9.1-79 <br />