Laserfiche WebLink
the Evergreen <br />r 0.*f'A0NSTRUCTI01_ <br />everett PERMIT PERMIT h0. 13370 <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING XXi MECHANICAL LI PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />JAMES TOBIN 1810 RAINIER EVERETT WA aR9111 _ <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRE S CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE Y <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE i <br />S <br />❑ NEW ❑ ADDITION 0 ALTERATION 0 REPAIR 0 DEMOLITION ❑ FENCE ❑ SIGN X5d WOOD STOVEIFIREPLACE INSERT <br />Install wood stove <br />PROPOSED USE OF BUILDING <br />Residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAY! REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNAT11 <br />OF CONTRACTOR OR AUTH OA EE1� <br />X 4Z— 9 5/ 84 <br />.�,-,cam <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT —BLOCK —OF <br />JOB AD <br />f�Rainier <br />PLUMBING <br />M CHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE — <br />W4 TER CLOSET (TOILET) <br />AIR COND. UNITS -- H.P. EA. <br />_ <br />BATHTUB <br />REFRIGEP4,,ION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />_ <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 />_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />_ <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />1 <br />STOVE — WOOD <br />7 <br />0— <br />ROOF DRAINS — RAINLEADERS <br />'METAL FIREPLACE 8 CHIMNEY <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />�— <br />SUB TOTAL <br />5 <br />SUB TOTAL S <br />PEI',MIT <br />S <br />PERMIT $ <br />1 n <br />-OD— <br />TOTALFEE$ <br />TOTAL FEE $ <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 />-]YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <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 />FIRE SPRINKLERS <br />REQUIRED <br />DYES ONO <br />MECHANICAL <br />0 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />17 <br />SO <br />3. FIRE HYDRANT <br />d. FIRE PROTECTION SYSTEM <br />S. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SptLC!] Tj IS IS 1(OU1PERMI L A <br />lL i l! ��JJ 11 <br />00 <br />I�..(.�•' <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC, BY <br />I PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />OI <br />- 5 EP u LI <br />Er <br />PP <br />C <br />ADDRESS FILE <br />