Laserfiche WebLink
the Evergreen <br />.. <br />C(NNSTRUCTION <br />CITY OF <br />everett <br />PERMIT <br />PERMIT NO.OH596 <br />CITY HALL 259-8745 <br />❑ COMBINATION ❑ 3UILOING kk MECHANICAL <br />❑ PLUMBING <br />EVERETT. WA 98201 <br />OWNER <br />MAIL ADDR'...F CITY <br />ZIP PHONE <br />Dennis A. Yanuszeski <br />6325 Folk Plano <br />9S2O3 iSa_,1na <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP PHONE LICENSE 1 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP PHONF LICENSL <br />Same <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP PHONE LICENSE F <br />E <br />❑NEW ❑ADDITION ❑ALTERATION ❑REFAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />L.0 <br />T_.4 II .0 -A I", rain .*n". <br />PROPOSED USE OF BUILDING <br />single family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONS RUCTION. <br />CONTRAC SIGN RE OF TOR OR UTHORIZED AGENT DATE <br />X 11 C <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT BLOCK_OF <br />JOB ADDRESS <br />6325 Polk Place <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />T FEE <br />WATER CLOSET(TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />LAVATORY ASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS — B T.U. M EA, <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B T.U. M <br />CLOTHES WASHER <br />I 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 />1 <br />STOVE WO <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />SUBTOTAL <br />SUBTOTAL i <br />4 <br />50 <br />PERMIT <br />E <br />PERMIT <br />TOTAL FEE <br />f <br />i TOTAL <br />FEE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />V,C.ANT SITE <br />OYES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />E <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />DYES ❑NO <br />MECHANICAL <br />7 <br />50 <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />% <br />50 <br />3. FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />O I it % $ 0 0 7.50 -= I1 <br />LO <br />YOUR R E C. E I PT o <br />THANK YGU <br />6, DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8_HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />V.C. <br />APPR. FOP ISSUANCE BY <br />2 0 10V 8 O <br />ADDRESS FILE <br />