Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUI1BING <br />evereri <br />�e <br />OWNER '.:.lIL .11 )IIH LliI: .'II' I'HnNL <br />Marina Iiayford 2405 Harrison 259-1233 <br />ITI <br />3 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Harold G. McIntosh 21 S.W. 107th 353-0708 MA CS RP 2330_ <br />z <br />C <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />9 <br />fA <br />m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT <br />❑COMBINATION <br />❑BUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW []ADDITION ❑ALTERATION ❑REPAIq <br />U i <br />VALUATION OF WORK <br />$3,700.00 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />repin and reroof <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR OPIESI <br />LOT J4 BLOCK 53& Parkhurst <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />s I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-11 P. EA. <br />I <br />FORCED AIR SYSTEMS—B.T.U. MEA. <br />I <br />JOB ADDRESS 11"� <br />2405 Harrison 3 <br />SPACE & WALL HEATERS — B.T.U. <br />UNIT HEATERS-B.T.U. <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />1 <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />_ <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />S <br />I <br />CLOTHES WASHER <br />1 <br />WATER HEATER <br />DISH WASHERS <br />1 <br />FAC. BUILT FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS <br />FLOOR DRAINS <br />1 <br />KITCHEN SINKS & DISP. <br />1 <br />SUBTOTAL $ <br />I <br />BAR SINKS <br />_ <br />1 <br />PERMIT $ <br />ROOF DRAINS - RAIN LEADERS <br />1 <br />TOTAL FEE S1 <br />I <br />SHOWER BATHS <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED 15 NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS A <br />PRIVATION 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 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 PER ORMA NCE OF CONSTRUCTION. <br />11/21/']'] <br />SERVICE SINKS <br />SUMPS -- SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />I <br />WATER HEATERS -ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />PERMIT S <br />TOTAL FEE St <br />WATER <br />SERVICE SIZE BLDG. SUPPLY SIZE <br />TIGNATUREOFCONTRACTUROR <br />AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YAROSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />I <br />BUILDING <br />s 3,700.00 <br />28100 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAD <br />PLUMBING <br />I <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />❑VES ❑NO <br />_ <br />MECHANICAL <br />I <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENALTY <br />SEC. 303(4) <br />I <br />I. <br />28100 - <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPERLY V VALIDATED IIe �,�11'nta 1 1 in <br />YOUR RECEliff <br />THANK YOU <br />a , <br />APPLICATIONACCEPTEDBY: <br />PLANSOIECKEDBY: <br />APPOOVE010BISSUANCE BY <br />K.C.eb <br />ADDRESS FILE Il I MR /j <br />