Laserfiche WebLink
ilia Evergreen <br />CITY OF- <br />everett <br />CITY HALL 959BUS <br />EVERETT, WASHINGTON <br />Rini <br />DEPT. OF COMMUNITY gUiLDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />evereti <br />PLUMBING �e�� <br />OWNER MAIL ADDRESS ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />54"T <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />LU <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />0] <br />2 <br />PERMIT <br />1113UILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION REPAIR <br />0 <br />z <br />F <br />ii <br />VALUATION OF WORK <br />S !7j98yy.Llfyp\ <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />K <br />a <br />DESCRIBE WORK MAP Wrirns <br />1582 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑GAT. ❑LPG. ❑ELEC. <br />GAS <br />LLGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR ES �}�L9 yy' <br />LOT BLOCK OF •'�'p '•'`L 4 �� 2 <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 />1 <br />BOILERS-H.P. EA. <br />I <br />_ <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />I <br />JDEI AD DRE55 <br />3A t.` xtr?f. }3Lmi, <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />1 <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />------------ <br />I <br />_ <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />i <br />WATER CLOSET (TOILET) <br />$ <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />1 <br />SHOWER <br />KITCHEN SINK & DISP. <br />�— <br />SUB TOTAL S <br />I <br />_ <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTALFEE $ <br />1 <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS 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 />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED T!IIS 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 />X <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />S <br />TOTALFEE <br />$ <br />SIGNATURE OF CONTRACTOROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREETSETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />BUILDING <br />,PBP�L <br />S 7lV*W <br />W <br />SIZE OF BLOC. <br />NO. OF STORIES <br />MAX.00C. LOAO <br />PLUMBING <br />FIREZgNE <br />BASEMENT <br />FIRE SPRINK L'RS <br />REQUIRED <br />DYES ONO <br />MECHANICAL <br />OTHER <br />I <br />SPECIAL CONDITIONS: <br />_ <br />I <br />_ <br />--- <br />PENELTY <br />SEC. 3031.) <br />I <br />TOTAL <br />w <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />R <br />+PPLI�TION ACCEPTED BY <br />PLANS CNECKEO BY. <br />APPPOV EU FOA ISSUANCE BY. <br />