Laserfiche WebLink
F <br />the EYer7reen APPLICATION FO" 14§1 <br />city Or CONSTRUCTION <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-0745 <br />EVERETT. WA98201 ]COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBI`:G PERMIT NO. <br />GENERALCONIRACTOR <br />MAIL ADDRESS <br />CILY <br />ZIP <br />PHO'.I <br />D <br />1� <br />Q <br />L�s/I <br />/ /LICIlM !7/t� <br />MICHANKALCONHACTO <br />f- <br />MAll ADDRISS <br />CITY <br />ZIP <br />pH0l1 <br />LICINSFY <br />L <br />PLUMBINGCONIRACIOR MAIL ADDRESS OIY ZIP PIIONI LICENSE 1 <br />CUSS Of WORK <br />-]DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />❑NEW [:]ADDITION ❑ALTERATION PREPAIR <br />VALUATION OI WORK <br />f <br />D'ScRudi WORK <br />PROPOSMUSI Of BIIDD11C <br />ad, <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXA INED THKAP- <br />PLICATION AND KNOW THE SAME TO BE TRUF 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 />SIGNATUR[ Of CONTRACTOR OR AUTHORIZED AGENT DATE <br />X ? 3 L <br />MECHANICAL <br />HUL of �(aIPHo I PROPIRl1 nH rN Fu Oa AnAul wuR eUPnsl <br />LOT _BLOCK —OF <br />' O " <br />FOR ADORISS <br />SS M,o <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE <br />FIT <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WmTIR CT0MTTOLIf II <br />AIRCOND UNITS -HP EA <br />BATHTUB <br />REFRIGERATION UNITS -HP EA <br />LAVATORY (WASH BASIN) <br />SHOWER <br />RIICHEN SINK A DISP <br />BOILERS -HP EA <br />GAS FIRED AC UNITS -TONNAGE EA --r1— <br />FORCED AIR SYSTEMS-0 T U M EA <br />1 <br />DI`.WASHIR <br />WALL HEATIRS-BTU M <br />I AUNDRY TRAY <br />UNIT HEATIRS-BTU M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WA.TER HIATER <br />CLOTHES DRYERS <br />URINAL <br />VINTILAIION fAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />1 LOOR DRAIN <br />AIR HANDLING UNIT- C F M <br />S'ACUUM BREAKERS <br />SIOVI <br />NOOF DRAINS -RAINLE AD[ IRS <br />MITAL IIRIPLACE A CHIMNEY <br />SINK (STRVICI-BAR. ETC) <br />SUB TOTAL <br />SUB TOTAL $ <br />PERMIT <br />E <br />PERMIT f <br />- <br />TOTAL FEF <br />S <br />TOTAL FEE E <br />SIDF YARD MTRACK <br />STREET SETBACK <br />RIAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FIE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SIIE <br />OYES ❑NO <br />FEES <br />VALUATION <br />Fit <br />TYPE Of CON1iT <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 />III ORWMS <br />FIRE SPRINKLERS <br />REQUIRED <br />VA 7NO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1 ENVIRONNILNIAL CHECK LIST <br />PENALTY <br />U11C <br />SEC R)Ral <br />7 BUILDING PLANS <br />TOTAL <br />T TIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />PERMIT VAUDA1 ION <br />WHEN PROPERLY S AIIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />5 GRADINGILXCAVATIONACLEARINGIGRUBBING <br />b DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />9.1.79 <br />