Laserfiche WebLink
A <br />the Evergreen CITY OF C" N ST R U CT I O N <br />everett PERMIT PERMIT NO.1095O <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 ❑ COMBINATION ❑ BUILDING CH MECHANICAL ❑ PLUMBING <br />OWNER MAIL AUDPLSS CHY ZIP PHONE <br />' Black Clauson 4425 South 3rd Everett 1 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY 'ZIP PHONE LICENSE F <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP "HONE LICENSE 4 <br />Natural Gas Equipment 1611 East Grand Everett 98201 258-2441 <br />PLUMBING CONTRACTOR MAII ADDRESS CITY ZIP PHONE LICENSE <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION El FENCE ❑SIGN ❑GARAGE <br />S <br />DESCRIBE WORK <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERT <br />LOT BLOCK -OF <br />I HEREBY CERTIFY THAT I HAVE R�AD AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN 'OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SICNAIUPE Or CONTRACTOR OR AUTHOMIED AGENT DATE <br />9425 South 3rd <br />X (O tu�r w->11owl_, <br />8/31/82 <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CI OSET (TOILET) <br />AIR CGND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />_ <br />LAVATORY (WASH BASIN) <br />BOILERS — N.P. EA. <br />_ <br />SHOWER <br />GAS FIRED A C. UNITS —TONNAGE EA <br />_ <br />KITCHEN SINK & 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 />C'_OTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C F/d <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />_ <br />'METAL FIREPLACE & CHIMNEY <br />SINK(SERVICE — BAR, ETC.) <br />yiatpr HPwt•nr <br />SUB TOTAL <br />SUB TOTAL _ f <br />2 <br />00 <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />TOTAL FEE S <br />5 <br />00 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR 1 ARE SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACAN T SITE <br />iIYES LINO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />f <br />SIZE OF BLDG. <br />NO, OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPFINKLERS <br />REQUIRE.) <br />DYES LNO <br />MECHANICAL <br />5 <br />00 <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />pENA, <br />Us C. <br />SEC. 303 (BI <br />2 BUILDING PLANS <br />TOTAL <br />5 <br />00 <br />3, FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPICE) THIS IS YOUR PERMIT <br />t <br />6955 i O O 5. 0 O }++- <br />0 <br />YOUR REG EIPT� <br />THANK YOU <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />AP, LIGATION ACC, BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />I I AUG 8 2 <br />