Laserfiche WebLink
MP Evorgwn <br />CITY OF <br />APPLICATION FOR <br />C JNSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA 98207 ❑COMBINATION <br />❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />/A"IL <br />MECHANICAL CONTRACTOR , MAIL ADDRESS CITY LIP PHONE LICENSE R <br />Z�n <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK rr++�� <br />❑NEW ❑ADDITION ❑ALTERATION Jq REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />DISC R�lBI WORK <br />PROPOSE USF of BUILOINc <br />�2, /A� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT 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 PFESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY Ol HER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />x <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BR)WOR /ATTACH FOUR �COPIES) <br />Lot BLOCK OF T'y1c�.e4S I':/1'1/FI-�4I /cFT, P <br />/I <br />LOB ADDRISs <br />4_7 4 <br />PLUMBING <br />MECHANIC <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOLIET) <br />AIR COND UNITS — HP EA <br />BATHTUB <br />REFRIGERATION II NRS—HP EA <br />v <br />LAVATORY (WASH BASIN) <br />BOILERS —HP EA <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS—B T U M EA <br />DISWASHER <br />WALL FIEA7E115-11 TIJ M <br />LAUNDNS' TRAY <br />UNIT HEATERS—B T V M <br />CLOTHES WMHER <br />EVAPORATIVE COOIERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />I VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS —RAINLE ADE RS <br />METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE - BAR, E TC ) <br />SUB TOTAL <br />SUB TOTAL S <br />PERMIT <br />S <br />PERMIT B <br />TOTAL FEE <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 ONO <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 />OI OROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECKLIST <br />PENALTY <br />U.BC. <br />SEC TUS(R) <br />2 BUILDING PLANS <br />TOTAL <br />B FIRE HYDRANT <br />A FIRE PROTECTION SYSTEM <br />5 GRADINGIE KCAVAT ION b C I EAR INGIGRUBBING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />6 DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC 0Y <br />PLAN$ CNCCK ED BY <br />APPR FOR ISSUANCE BY <br />9.179 <br />