Laserfiche WebLink
Ow Ewrpw <br />CRY OF <br />APPLICATION F( <br />LONSTRUC T10 <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 2S9-8785 <br />EVERETT, WA 98201 ❑COMBINATION <br />❑ BUILDING ❑MECHANICAL <br />R w <br />❑PLUMBING PERMIT NO. <br />n <br />Pll'MRING CONTRACIO•l MAIL ADDRESS CITY ZIP MONF LICINAf F <br />CL ASS Of WORK <br />❑NEW ❑ADDITION ❑ALTERATION REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VAIUA71ON Of WORK <br />•C,6 <br />D�`RIBE L�Nf77'4hf /1(c40�iLf/t <br />PROP)SID 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 WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />pR NOT. THE GRANTING OF A PERMIT DOES NOT PRESI IME 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 />Y <br />X r <br />LEGAL DESCRIPTION Of PROPERTY (SHOWN BELOW OR ATTACH FOUR COCKS) <br />'odd '�; z tL��f �lA,1 <br />WT BLOCK » �_Of - '- <br />I' <br />-, • % 1c,. //E' <br />LOB AOORI SS <br />I Cl SCAN, <br />►LUMBING <br />HANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TM OF EQUIPMENT <br />FEE <br />WATER CLOSET f'OLIETI <br />AIR COND UNITS-H P EA <br />BATHTUB <br />REFRIGERATION UNITS -HP FA <br />LAVATORY,WASH BASIN) <br />BOILERS-H.P EA <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />KITCHEN 5 NK L DISP <br />FORCED AIR SYSTEMS-8 T U M EA <br />DISWASHt 1 <br />WALL HEATERS-B T U M <br />LAUNDRY TRAY <br />UNIT HEATERS-B T U M <br />CLOTHES WASTER <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- CF M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS -RAINLEADERS <br />METAL FIREPLACE L CHIMNEY <br />SINK (SERVICE -BAR, ETC 1 <br />SUB TOTAL <br />Wil TOTAL <br />PERMIT <br />I <br />PERMIT I <br />TOTAL FEE <br />I <br />1 <br />1 TOTAL <br />FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST�11 <br />R <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />RE DROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />❑YES ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC <br />SEC 30)(8) <br />Z BUILDING PLANS <br />TOTAL <br />I FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />S GRADINCIF%UVATIONLCIf ARINGILRUB8ING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />8 HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />94-79 <br />