Laserfiche WebLink
n <br />IAREY.o..A APPLICATION FOR <br />CM OF CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />MAIL ADDRESS OWNER 1 ESS CIl1 F ZIP PHONE S8 <br />I 3 65y-S� <br />ARCT OR <br />MAIL ADDRESS <br />\ <br />� <br />� <br />�P <br />l��� <br />/ <br />G[NTIRAICCONiRAC10RIR <br />MAMADDRESS <br />CO, <br />PHONE LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />PLC SIRNG CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE IICFNsI/ <br />CLASS Of WORK <br />❑NEW ❑ADDITION <br />❑ALTERATION ❑REPAIR <br />❑DEMOLITION <br />❑FENCE <br />[]SIGN <br />❑GARACE ❑BUILDING RELOCATION <br />VALUAl 101 01 WORK <br />E <br />DESCRIBE WORK <br />PROIrossE Gr RwLQmc <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 PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ]ATE <br />LEGAL Of SCRIPTION Of PROP[ RIV (SHOWN BELOW OR ATTACH FOUR COPII51 <br />LOl _BLOCK —OF <br />!Y' <br />IOR ADDRESS <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET I TOLIEII <br />AIR COND UNITS —HP EA <br />BATHTUB <br />REFRIGERATION UNITS—H P EA <br />LAVATORY (WASH BASIN) <br />BOILERS —HP EA <br />SHOWER <br />CAS FIRED AC UNITS —TONNAGE EA <br />KITCHEN SINK 8 DISP <br />FORCLD AIR SYSTEMS —BTU M EA <br />DISWASHER <br />W/' L HEAIE115-13 T U M <br />LAUNDRY TRAY <br />UNIT HEATTRS—B T U M <br />CIOTHESWASHER <br />IVAPORATIVI V/OLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION TAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM BREAKERS <br />s10Vf <br />ROOF DRAINS—RAINLEADERS <br />NET TAL FIREPLACE &C14IMNEY <br />SINK (SERVICE —BAR. I IC 1 <br />SUR TOTAL <br />SUB TOTAL B <br />,O <br />PERMIT <br />S <br />FCAMIT B <br />OU <br />TOTAL FEE <br />S <br />TOTAL FEE B <br />SERF YARD SETBACK <br />STREET SETBACK <br />REAR YARD 51 TRACK <br />PLAN CHECK NUAIHLR <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT <br />VACANT SIZE <br />❑NO <br />USESTYPE <br />FEES <br />VALUATION <br />FEE <br />Of CONSI <br />OCCUPANCY GROUP <br />NO OF DW;LLING 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 />111 DRDUAIS <br />IIRL SPRINMLRS <br />REQUIRE—, <br />I]YIS FIND <br />MIC14ANICAL <br />AMROVALS <br />BY <br />OAT[ <br />OTHER <br />1 ENVIRONMENTALCHECK LIST <br />PENALTY <br />UBC <br />SIC BBR/) <br />2 BUILDING PLANS <br />TOTAL <br />FIRE HYDRANT <br />A FIR( PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />5 GRADINGIKCAVAIIONB CLLARINGICRUBBING <br />e DRAIhACE <br />7 ENVIRONMENTAL IMPACT STA7LMENT <br />8 HEALTH DI iTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />91;9 <br />