Laserfiche WebLink
MP EPRrgmn <br />CITY OF <br />APPLICATION FOR <br />CONSTRUCTIOi . <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 COMBINATION <br />❑ BUILDING ❑MECHANICAL El PLUMBING PERMIT NO. <br />ARCHITECT OR O[SIGNI R MAIL ADDRI SS CITY ZP PHONE <br />/IS 'A� Arm .\ <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE HCINSL I <br />MICHANICAL CONTRACTOR MAIL ADDRESS (11Y ZIP PHONE LICENSEE <br />PIUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />C LASS Of WORK <br />❑NEW ❑ADDITION ❑MURATION ❑REPAIR DEMOLITION ❑FENCE ❑SIC,N ❑GARAGE ❑BUILDINGRELOCATION <br />♦ALL'ATION Of WORK <br />DISCRI&E WORK <br />L'r d - r li Nt r'MITn�� <br />PROMS[0 USE Of BUILDING <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 />PROVISION; 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 DATE <br />•'�'//Ef !-'/C /13 /(ti'� 1 <br />xi � 1, :..L �LZ L", <br />LLCM DISCRIPIION Of PROPIRTY (SHOWN BELOW OR ATTACH FOUR COPIESI <br />17.1 IF - I. " <br />IOT _BLOCK "'22 DI 1 (..+ i c �" 1-v.=r:cif 2Iv <br />A 5 ('Fr: �L F+T I:I ),-I) /.. ✓. I. 3 (- 1'L N rs <br />pollADDRESS <br />-/ it tieT1°161- !'LI P1 %%,LU.V <br />PLU.MBINE <br />MECHANICAL <br />NO, <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />SSAII, YSEIFOLIEII <br />AIRCOND UNIIS-HP fA <br />N+1"L'H <br />REFRIGERATION UNIIS-TIP LA <br />lAM'AIOHY (WASH BASIN( <br />BOILERS -HP LA <br />SHOWER <br />GASFIREDAC UNIIS-IONNAGE [A <br />KITCHEN SINK A DISP <br />IORCID AIR SYSIEMS-R T U M LA <br />DISWASHER <br />WAIL II(ATIRS-BTU M <br />LAUNDRY TRAY <br />UNII HEATERS -If T U M <br />(IOTHESW'ASIIIR <br />L =�RAI:VE000LERS <br />WATER MEAIER <br />CLOTHES DRYERS <br />URINAL <br />VL NTILATION FAN <br />DRINKING FOU%TAI% <br />RANGE HOOD <br />FICIOR DRAIN <br />AIR HANDLING UNIT- C F M <br />VACUUM BREAKERS <br />S10V[ <br />ROOF DRAINS - FAINT IADF RS <br />Atl TAL FIREPLACE A CHIMNEY <br />SINK (SERVICE -BAR. ETC) <br />SUB TOTAL <br />SUB 70TAI S <br />PERMIT <br />S <br />PERMIT I <br />TOTAL FEL <br />S <br />TOTAL FEE 5 <br />SIOF YARD SETBACK <br />SIRIIT SIIRA(I, <br />RI AR YARD SETBACK <br />PI A'. I HE C I. NI]IIII R <br />PLAN <br />rlE <br />CHECK FEE <br />RECEIPT I:O <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ❑NO <br />FEES <br />VALUATION <br />T(E <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DW [CLING 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 />141 DROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES ONO <br />MECHANICAL <br />APPROVALS <br />IT <br />DATE <br />OTHER <br />1 F NVIRONMLNTAL CHECK LIST <br />PINALTY <br />UBC. <br />SIC 707(I) <br />Z BULL DING PLANS <br />TOTAL <br />1 fIRE HYDRANT <br />A FIRE PROTECTION SYSTEM <br />5 GRADE NGIE XCAVAT ION& CC EAR INGIGRUBBI NG <br />PERMIT VALIDATION <br />WHEN PROPERLY VALID YTED (IN THIS SPACE) THIS 15 YOUR PE RMI7 <br />& DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATIM[NT <br />B HEALTH DISTRICI <br />APPLICATION ACC By <br />PLANS CHECK[D BY <br />APPR FOR ISSUANCE BY <br />91 79 <br />