Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />CITY MAIL n9999s <br />IVI RII T. WAGMINGTDN <br />95901 <br />DIN. OF COMMUNITY BUILDING <br />DIVELDPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e�� <br />OWNER MAIL ADDRESS ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />R] <br />PERMIT <br />M13UILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEIv El ADDITION ❑ALTERATION ❑REPAIR <br />� <br />Z <br />F <br />G <br />VALUATION - OF WORK <br />S IN./Q1N1_"Mv <br />❑DEMOLISH ❑FENCE MIGN ❑SWIMMING POOL <br />w <br />CL <br />DESCRIBE WORK TIIMT .F <br />1857 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑ ❑LPG. ❑ELEC. <br />GAS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <br />_ <br />N0. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-M.P. EA. <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />_ <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />I _ <br />^ <br />JOB ADDRESS tl <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />1 <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />i <br />VENTILATION FAN <br />RANGE MOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET (TOILET) <br />g <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUB TOTAL 5 <br />1 <br />DISHWASHER <br />PERMIT S <br />LAUNDRY TRAY <br />TOTAL FEE $ <br />I <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 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 -RESUME 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 />�J/ <br />xI c• <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />E <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREEr SETBACK <br />REARYARDSFTBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USEZONE <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 <br />UNITS <br />�— <br />I <br />BUILDING <br />S WNW <br />th <br />SIZE JF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES ❑NO <br />MECHANICAL <br />MECH <br />I <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />1 <br />PENELTV <br />SEC. 00](B) <br />I <br />TOTAL <br />2L bO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IIN THIS SPACE) THIS IS YOUR PERMIT <br />APPLICATIONACCEPTEOBY. <br />PLANSCNECKEOBY: <br />APPROVFDTOA IGAI<NCE BY. <br />/A <br />