Laserfiche WebLink
fMEvFrgTBBB APPLICATION 1`01 <br />CITY OF CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 v <br />EVERETT. WA98201 F-1 e.�....u�.- <br />❑MECHANICAL ❑PLUMBING PERMIT NO. <br />!Y!PliE <br />e <br />OWNER <br />MAIL AUDNI SS <br />CITY <br />ZIP <br />PHONE <br />5?�p3827 <br />G,�.odd <br />ARCHITICTORUISICNIR <br />MAIL ♦DRISS <br />CIT' <br />ZIP <br />PHONE <br />C7MXAL CONiXM FOR <br />MAIL ADDRISS <br />❑" <br />ZIP <br />PHONE LICENSE IFSTorl <br />44iff,/51 <br />Alpm/f- <br />MIOIANICM CONTRACTOR <br />MAIL ADDRESS <br />CON <br />ZIP <br />PHDNI LICENSER <br />NUMBIM: CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE IT <br />❑NEW ❑ADDITION )KALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />N k LU AA O�r NU�LxA <br />L / j ( <br />DESCNI RI <br />%if7s�ioir. &T,'1&,f770AJ5 <br />PROPOSED USE OF BUILDING <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 WORT: 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 />SIGN TUBEOF CONTRACT AUTHORIZED AGENT L�DATE y�E <br />`�,` <br />LEGAL DISCRIPTIONOT PROPERTY(SHOWN BELOW OR ATTACH fOURCOPIES) <br />LOT _ BLOCK —Of <br />ION AI>HR//L �� L EVW1 <br />PLUMBING <br />X CHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSE I(IOOET) <br />AIR COND UNITS -HP IA <br />BATHTUB <br />REFRIGERATION UNITS -HP [A <br />LAVATORY (WASH BASIN) <br />BOILERS -HP [A <br />SHOWER <br />1z <br />cqc, <br />GAS FIRID AC UNITS-TONNAG[EA <br />KIICII[N SINK A DISP <br />FORCED AIR SYSTEMS -BTU M EA <br />DISWASHER <br />WALL. HIATIRS-111U M <br />LAUNDRY TRAY <br />UNIT H1 ALL EI1U AT <br />CLOTHISSYASHIR <br />IV'APORATIV'E COOLERS <br />WAI I R ALAI I R <br />CI OTHI S DRYERS <br />URINAL <br />VENTILATION MN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- C I <br />VACUUM BREAKERS <br />STOVE <br />ROOT DRAINS-RAINI[AD[RS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SE RV ICI -BAR, E lC ) <br />SUB TOTAL <br />SUB TOTAL S <br />PERMIT <br />$ <br />PERMIT S <br />TOTAL FEE <br />S <br />V(-J <br />TOTAL FEE S <br />SIDE Y ARD SETBACK <br />STRI IT S[TRACK <br />RI AN YARD SI ILIA( K <br />PLAN CHICK NUMBER <br />PLAN <br />FIE <br />CHECK TEL <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT Sill <br />❑YES DNO <br />FEES <br />VALUATION <br />FEE <br />TYPE Of CONSI <br />OCCUPANCY GROUP <br />NO OF DWELLING LINI15 <br />BUILDING <br />S/IJ� <br />•� <br />SIZE OF BLDG <br />NO OF STORIES <br />%TAX OCC LOAD <br />PLUMBING <br />A <br />20 <br />FIRE ZONE <br />BASEMENT <br />OE UROOmS <br />TIRE SPRINKLERS <br />REQUIRED <br />C]YFS ❑NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />I. ENVIRONMENTAL CHECK LIST <br />PINAI IY <br />SIC l07(ai U BC <br />2 BUILDING PLANS <br />TOTAL <br />7 FIRE HYDRANT <br />A [IRE PROIICTION 51STIM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />5 GRADLNGILXCAVATION A CLEARING!GRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />8 HEALTH DISTRICT <br />APPLICATION ACC HY <br />L <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />L c. <br />9.1-79 <br />