Laserfiche WebLink
TAB Ewrpnsn APPLICATION FOR <br />CITY OF (:ONPERMIT <br />TION °Be <br />everett <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL. 2598745 <br />EVERE <br />O%%NkR r. WA 98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />o/1YNIR (� Auu(UDNI Ss CITY ZIP <br />ARCHITICI OK UISIGNIR MAIL ADORE%% �C`��+--�� kl( � ' �.J �1 <br />GIN[RALCONiRACTOR MAIL ADDRESS CEEY ZIP PHONE <br />LICENSE 1 <br />7NEW _ ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE CIRELOCATION <br />VALUATION OF WORK <br />f <br />DISCR1B1 WORK <br />Im-, <br />PROPOSED U 5 1 or BU ILDINc <br />e; h <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 />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 FERFOPAIANCL OF CONSTRUCTION. <br />R <br />SIGNATURE OF CONTRACTOAUTHORIZED AGENT DATE <br />L[GALOSCRIPEION OI PROP)REV(SHOW'N BELOW OR ATTACH FOUR COPRA <br />LOT 'LOCK_OF <br />RED. IUII <br />: T � ^� <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE Of FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />W'All R ClOSf i IiOI 1F11 <br />AIR COND UNITS—H P EA <br />BAIHIUB <br />RI I RIGFRATION UNITS —HP [A <br />UVATOR) (WASH BASIN) <br />IIOILERS—HP [A <br />SHOWER <br />GAS F IRE D A C UNITS-70NNACL EA <br />KITCFIEN SINK A DISP <br />IORCID AIR SYSTEMS —BTU M EA <br />DISW'ASHIR <br />WALL HEATERS-11 T U M <br />LAl1NDR1' TRAY <br />UNIT HIATERS—B 7 U AT <br />0 <br />C I Ol 111 S W'ASHCH <br />I VAPORATIVC COOLERS <br />W AI f R Hl A R H <br />CTOTHI S DRYI RS <br />URINAL <br />VINIILATION FAN <br />UR INKING FOUNTAIN <br />RANGE FLOOD <br />11 OOIT DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM BRIAKfRS <br />S10A'1 <br />ROOF DRAINS—HAINLEAUL RS <br />ME TAT FIREPLACE A CHIMNEY <br />SINK (SERVICE —BAR. ITC) <br />SUB TOTAL <br />SUB TOTAL f <br />Q <br />PERMIT S <br />PERMIT f <br />70TAL FEE 3 <br />TOTAL FIE f <br />SIDE LARD Sf 111ACK <br />STREET SETBACK <br />REAR YARD S[1BACK <br />PI AN I III CK hLMIR R <br />PLAN <br />111 <br />CHECK FEE <br />RICE IPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />SMAX <br />SIZE OF BLOC <br />NO OF STORIES <br />OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />III DROOMS <br />FIRE SPRINKLERS <br />RfQUFIYFFSIRED FIND <br />A1ICMANICAL <br />/_ <br />N <br />DA <br />VV <br />APPROVALS <br />BY <br />DATL <br />OTHER <br />1 ENVIRONNif NTAL CHECK LIST <br />PENALTY <br />UBC <br />SEC lONal <br />Z BUILDING PLANS <br />FIR[ HYDRANT <br />TOTALQQ <br />YJ <br />V <br />A FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />W HLN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />5 GRADING;[ XCAVAI ION A CLLARINGIGRURRING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPI ICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />91 79 <br />