Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2SM745 <br />EVERETT. WA 9=1 <br />F ';ONSTRUCTIOV <br />PERMIT <br />❑ COMBINATION RX BUILDING G MECHANICAL <br />PERMIT NO. 12414 <br />❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />tAnRA TRAAISON 2105 Vireini Fverett WA 98201 252-7871 <br />ARCHITEDTORDESIGNER MAILADDRESS CITY ZI PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />Co 3402 - 11P"' <br />°10 Fverett <br />98204 <br />355-1112 <br />_ <br />Senior Svcs of Snoh <br />MECHANICAL CONTRACTOR <br />MAILADDRESS <br />Cltt <br />21P <br />PHONE <br />LICENSET <br />SENIOSS2431H <br />223-01 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />21P <br />PHONE <br />LICENSE <br />cLA" Or wo•.. <br />❑ NEW ❑ADDITION ❑ALTERATION X® REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑ WOOD STOVEIFIREPLACE1NSERT <br />VA! 'ATION OF WORK <br />f 800.00 <br />rnnF - rmmrinBition <br />PROMISED use OF BUILDING1 <br />HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Residenncee <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. LL PROVISIONS OF LAWS AND ORDINANCES <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT —BLOCK —OF <br />WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. 9 <br />SIG U CONTR i ORIZED AGENT /120/%E3 <br />tS <br />JOB ADDRESS <br />2105 Virginia <br />MECH�4IICAL <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA, <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS—B.T.U. M <br />CLOTHES 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.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEAOERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE. — BAR. ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUBTOTAL <br />i <br />SUBTOTAL f <br />PERMIT <br />f <br />PEflMIi f <br />TOTAL FEE <br />f <br />TOTAL FEE f <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />i,'YES 7 NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />14 <br />50 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />!s800.�0 <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />['YES �NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (A) <br />2. BUILDING PLANS <br />TOTAL <br />14 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5.GRADING`. <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED pN THIS SPACEI THIS T <br />T IT I Q 7 O d <br />i\ <br />YOUR RECEIPT •� <br />S. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENTB. <br />HEALTH <br />APPLICATION ACC. <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />THANK YOU <br />1 3 slp 8 3 <br />ADDRESS FILE <br />