Laserfiche WebLink
, <br /> ,,;�� F�rrcrei�n - �PLICATION FOR�� ����„ <br /> � ��, ��� �.ONSTRUCTION � e <br /> everett PERMIT <br /> DEPT. OF COMMUNITY DEVELOPM[NT SERVICES <br /> CITY HALL 2548715 <br /> EVERETT,WA9B201 ��OMBINATION D� BUILDING ❑MECHAhICAL ❑PLUMBING PERMIT NO. <br /> OWNFR MMl�00RF55 CIIY lIP PHON( <br /> JEfF2�'� I �I��� a�,n �,uc� R�. E-✓�,e�,r �avi Z�-37sL <br /> �RCXR[CTORD6IGNER ��MIADDRl4 ❑iY 21V . PNONE I <br /> ERAL CONTRACIOR MAII ADDRESS CIIY 21P PNON[ UCENSE I <br /> ��I <br /> M[CNANIUI CONTR�CTOR MMl ADDP65 UiY LIP PNONE IICENSE I <br /> I <br /> VLUMBING[ONTN�CIOR M�It�ODRF55 CIiY 21P PNONF IICEN5f1 i <br /> I <br /> I <br /> CUSS Of WONK �, I I <br /> ❑NEW ❑ADDITION ipALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUIIDING RELOCATION I <br /> VAWATIOH OF WORK I' <br /> � � SlI� ��/�///yy��� � �A I <br /> OFXRIBF WOIIK �� L�m� �� � IN � (� ^�'^�^�V"' J'�W • • <br /> PROPOSEDUSE OF BUILD�NG 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- � <br /> � PLIGTION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL �� <br /> IEG�L DFS[RIPTION Of MIOP[RTY�SNJw eei W OR ATTACN iOUR COPIE5) PROVISIONS OF LAWS AND ORDINANCES COVERNING THIS TYPE ! <br /> �,^ . OF WORK WILL B� COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> iot�eioc��or OR NOT. THE GRANTINC OF A PERMIT DOES NOT PRESUME TO i <br /> CIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF I <br /> ANY OTHER SiATE OR LOCAL LAW REGULATINC CON51 RUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. I <br /> SIGNATURE OF CONTRACTO OR AUiHORIZED AGENi DATE <br /> �oe�3rE S �l� it/ X �- - � <br /> � ►LUM�ING ME l <br /> NO. TY/E OF FIXTU�E FEE N . TY�E OF EQUI►MENT FEE <br /> ' WATER CLOSET(TOIIET� AIR COND.UNITS-M.P.EA <br /> ' BATHTUR ftEFRIGERAiION UNITS-H.P.'A <br /> � UVATORY pVASH BASIH) BOILERS-M.P.EA <br /> �'� SHOWER WS FlNEOAC UNITS-TONNACF EA <br /> I <br /> ' KITCHEN SINK L DISP. FORCFU AIR SYSTEMS-B.T.U. M EA <br /> UISWASNFR wAIL HEATERS-B.T.U. M <br /> ' LAUNdIY TNAY UNIT HfATERS-B.T.U. M <br /> . " *���� CIOTHES WASHER FVAPORATIVE COOLfRS <br /> � � �7 , WATER HE�TER CLOTHES DRYFRS , <br /> � � `p :_, URINAL VENTILATION FAN <br /> � �' � DRINKING FWNTAIN RANGE HOOD <br /> � � o.a �, FLOOM1 DRAIN AIR MANUIING UNIT- GEM. � <br /> . , �,,.;�',' VACUUM BREAKFRS STOV[ � <br /> . � �i��i" : ROOF dtA1N5-RAMIEADFRS METAL FlREPUCf 8 CNIMNEY <br /> � SINK(SERVICE-BAR,ETC.) � <br /> 4 � <br /> � . fU�TOTAL su�roui s ' <br /> � rERMIT t rFRMIT { <br /> TOTAL fFE f TOTAI FFF f <br /> � SIDE YARD SEiBACK STREET SETBACK RfAR YA6D SETBACK PLAN CNECK NUMHFR PUN CHFCK FfE , <br /> FFE FECEIPTNO. ' <br /> 1�5E ZONE LOT ARFA VACANT SITE <br /> � � OYES ❑NO FEES VALUATION �EE . <br /> TYPE OF CONST. OCCUPANCY GftOUP NO.OF OWEIIING UNITS <br /> BUILDING y rOoOd <br /> SIZE OF BIDG. NO.OF STORIFS MA%.OCC.IOAD � . <br /> PIJMBING <br /> FIRE 20NE BASEMFNT flfOROOMS RFQUIREDKLERS � <br /> MFCNANIGiI <br /> OYES �NO <br /> AlMOVAIf �N DAiE OTHER ' <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> 2. BUILDING PLANS SEC.30Ha) <br /> ). FIRE HYDRANT 1OTAL S <br /> �, fIRE PROTECTION SYSTFM ►F�MIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN TMIS SPACE)TMIS IS YOUR PERMIT <br /> S.GRADINGF%CAVATION 8 CIEARINGIGRUBIiING <br /> 6. DRAINAGE „ - 1 �/ G l�r-^ G. j I h-1 : ��(�L 1��.�.' U <br /> L ENVIRONMENT�L IMPAQ STATEMENT �� h 1� �y ,��)(�( :. I•-� •'�6-L R� S�l I��_. ' ��I � <br /> E. HEALTH OISTRIQ „ � c ' e ,.) .� 1'�-�"/ G V.h'� �j <br /> APPLICATION ACC.flY PUNS CHfCKED BY APPR.FOR ISSUANCf OY ^ � , � q <br /> C �. , ✓�iY�_;ir._! �4$ pF �.� Oli i)2 �� : � <br /> , l.•1���� � 'y; /� xN`�v IG i.a�,i? <br /> ; t '. , . , <br /> �.iav 1 I^` � '" �`. <br />