Laserfiche WebLink
ME Em gro En <br />CITY OF <br />APPLICATION FOR <br />everett ,,,.ONPERMITTION <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2598745 <br />EVERETT. WA9B201 []COMBINATION ❑ BUILDING <br />❑MECHANICAL <br />❑PLUMBING <br />PERMIT NO. <br />OWNER <br />`ovr S , 4/�SL',u <br />MAIL ADORL SS <br />'?8/D CRTN i'i�- <br />CITY <br />L <br />ZIP <br />PHONE <br />-5 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />5e/_Yc <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRISS City ZIP PHONE LICENSE <br />PLUMBING. CONTRACTOR MAIL AGIRISS CIt\ ZIP PHONE LICENSE <br />EJNEW ❑ADDITION ❑ALTERATION ❑RFPAIR ❑DEMOLITION ❑FENCE ❑SIGN L3GARAGE ❑BUILDING RELOCATION <br />VALUATION 0E WORK <br />f ,I OLIV e'o <br />DESCRIBE WORK <br />OUILn AA:w &,41?46-c= <br />PROPOSED USE Of BUILDING <br />9= FOR 2- L 4 <br />I HEREBY CEk.IFY 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 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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />LEGAL DESCRIPTION OF PROPERTY [SHOWN BELOW OR ATTACH FOUR COPIES) <br />�q 2 Pear :-�� /3E' c LV P4 i�'< <br />LOT r r, BLOCK_oF <br />LOB ADDRESS <br />7?IL RA A) 7- <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOLIFTI <br />AIR COND UNITS-H P EA <br />BATHTUB <br />REFRIGERATION UNITS-H.P EA <br />LAVATORY (WASH BASIN) <br />BOILERS -HP EA <br />SHOWER <br />GA$ FIRED AC UNITS -TONNAGE EA <br />KITCHEN SINK & DISP <br />FORCED AIR SYSTEMS-B T U MIA <br />DISWASHER <br />WALL HEATERS -BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS-B T U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />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 -RAINLFADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE -BAR. ETC 1 <br />SUN TOTAL <br />SUN TOTAL IF <br />PERMIT <br />f <br />PERMIT If <br />TOTAL FEE <br />f <br />TOTAL FEE f <br />SIDEYARD SETBACK <br />/ <br />V /-LC= i <br />STREET SETBACK <br />1210 -Lei <br />REAR YARD SE TRACK <br />w / I_._ I <br />PLAN CHECK NUMBER <br />C//�ap� <br />0 0 <br />PLAN CHECK FEE <br />FEE C'j RECEIPT NO. <br />ems_ <br />USE ZONE <br />LOi?_ Zo <br />yAE5 SE <br />F$ D <br />FEES <br />VALUATION <br />/[[ <br />TYPE OF CONST <br />Waoi7 F/ 4M,: <br />OCCUPANCY GROUP <br />/' *-I ` / <br />NO OF DWELLING UNITS <br />BUILDING <br />SIZE OF BLDG <br />2o,k ZY IrEGrI <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />`�. <br />BI OROOMS <br />FIRE SPRINKLERS <br />REQUIR <br />IDYFS O <br />MECHANICAL <br />APPROVALS <br />fT <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U BC <br />SFC Jmlq <br />Z BUILDING PLANS <br />1 FIRE HYDRANT <br />TOTAL <br />OV <br />I FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADINGIEKCAVATION f CLEARINGIGRUBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />9 1-79 <br />