Laserfiche WebLink
r <br />the EYB[BEBln 1 P P L I CA T I O N F O "' <br />CITY OF CONSTRUCTION <br />everett PERMIT E+ <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 T{�( <br />EVERETT, WA98201 ®COMBINATION ® BUILDING ❑MECHANICAL IJPLUMBING PERMIT NO. <br />OWNER MAIL ADDRISS CITY ZIP PHONE <br />Y!s ;Icnl„ /arL<l)r.,K 3,5-,/�-(i, !1<. 4y&,-e77 9TC qSi /"i7-S <br />ARCHITICT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />CENTRAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />LICENSEE <br />.[Y.ad Pe (�)Clh S & <br />g507 = / /f 44 b,9 'q F <br />.5/I/611, <br />9fr Z i l S'L•CC SS �C' l��f <br />h(nr' -J/�/ —/•/ <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />LIP PHONE <br />LICENSE E <br />PIUMBINC CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />LICENSEE <br />CLASS OF WORK <br />❑NEW ❑ADDITION NALTERATION UREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />Df SCRIBE WORK u.,.I ty X.I;, r1, -TLC e, •�I 131xf7 TYr:n .�nl.l 1>r,cl u,,. �`-'/41Kf ' <br />3 � 5 -PC. IA 1..m <br />raoroslD usl of RunolNc C /Y4/Y !j iRyK Ti rn.n <br />�[�,)7c o <br />$;;IgcA P�un,ly%O <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED T IS 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 QF CONTRACTOR OR AUTHORIZED AGENT DATE <br />X -7 -'6, ' <br />u A, IscRlruoNOF PROPIXTY(5110WN 6DOW OR AITACH IOUR COPHSI <br />C� <br />LOT .>—/ BLOCK jfLg OF jV'Y'%I n,,, . M <br />,4 �3 Or78 • 0On T-< <br />FOR AOURI SS <br />-- � = 9f- aS <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 —HP [A <br />UVAIORY (WASH BASIN) <br />HOILERS—H P LA <br />SHOSVE R <br />GAS IIRF I) A C UNITS —TONNAGE EA <br />KITCHEN SINK A DISP <br />FORCED AIR SYSTEMS—B T U MCA <br />DISWASH[R <br />WALL HE ATE RS—BTU M <br />LAUNDRY TRAY <br />UNIT HEATI RS-0 T U M <br />CLOIHLS WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLO7HIS DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />I IOOR DRAIN <br />AIR HANDLING UNIT— C f M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS—RAINLI. AD[ITS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE —BAR. FTC, <br />SUN TOTAL <br />SUB TOTAL S <br />PERMIT <br />S <br />PERMIT S <br />TOTAL FEE <br />S <br />TOTAL FFE S <br />SIDE YARD pE1BACK <br />STREET SETBACK <br />RIAR YARD SETBACK <br />' <br />PLAN CHECK NUMBER <br />Y �,. <br />O 2 <br />PLAN <br />Elf <br />r $ 3 <br />CHECK FEE <br />RECEIPT NO. <br />_ <br />5 <br />US[ ZONE <br />LOT ARIA <br />VACANT Slik <br />DYES KIND <br />FEES <br />VALUATION <br />fit <br />TYPE Of COAST <br />Y—_IJ <br />OCCUPANCY GROUP <br />GlT[ V4— cIJ <br />NO OI DWELLING UNITS <br />_ <br />lid ) <br />BUILDING <br />S <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />7 <br />PLUMBING <br />FIRE 2ON( <br />HASEMENI <br />EIE GROOMS <br />TIRE SPRINKIIRS <br />RLQUIRID <br />(IYIS f� <br />MECHANICAL <br />AP►ROVAL$ <br />BY <br />DATE <br />OTHIR <br />1 [NVIRONMLNTAL CHECK LIST <br />PENALTY <br />UBC <br />SEC JOXa) <br />2 BUILDING PUNS <br />J FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />TOTAL <br />L <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />!/AHD <br />C S / <br />p <br />{� T/LAr <br />5 GRADINGII XCAVAHON A CLIARINGIGRUBBING <br />6 DRAINAGE <br />7 FNVIRONMENTAI IMPACT STATEMENT�pa+ACw <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS <br />�,C IHHECKKED BY <br />RIl <br />APPLE FOR ISSUANCE BY <br />9.1-79 <br />