Laserfiche WebLink
the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING a MECHANICAL a PLUMBING <br />everett <br />,,e <br />OWNER MAIL ADDRESS ,-iP PHONE <br />JAtii@S C�r�r-r-�;�Y ��►-�� 331— '7CoO <br />ARCHITECT OR DESIGNER MAIL DRESS PHONE LICENSE NO. <br />m <br />J <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />J►�..,g � - � GONs txa <br />z <br />c <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT <br />QCOMBINATION <br />❑BUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />[A <br />91,NEW ❑ADDITION []ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />S -t oco0. OO El DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />cloJL/ Y ¢ L/h/ r ; ZSt 7( <br />PROPOSED USE <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY IS BELOW OR ATTACH <br />FOUR <br />��C��OPPI�IpEESI -�T7 <br />LD1L.4_`Cl BLOCK -I -OF eID ��S.-T <br />- -- <br />JOB ADORES:, <br />3-�10 <br />TYPE <br />OF ENERGY <br />❑GAS ❑ELEC. <br />NO. <br />TYPE OF EQUIPMENT <br />AIR COND. UNITS-H.P. EA. <br />FEE <br />$_ 1 <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />SPACE & WALL HEATERS - B.T.U. <br />UNITHEATERS-B.T.U. <br />1 <br />PLUMBING <br />N I <br />FEE TYPE OF fl%TURF OR ITEM _ yS <br />BATH TUBS —� <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTIL.9TION FAN <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />' <br />CLOTHES WASHER <br />I <br />_-WATER <br />HEATER <br />DISH WASHERS <br />I <br />DRINKING FOUNTAINS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />FLOOR DRAINS <br />GAS. SYSTEM: NO OP OUTLETS <br />4. <br />KITCHEN SINKS & OISP. <br />I <br />SUB TOTAL S <br />Q <br />BAR SINKS <br />I <br />PERMIT <br />ROOF DRAINS - RAIN LEADERS <br />SHOWER BATHS <br />TOTAL FEE § Z j0O <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED TI4IS AP. <br />PLICATION AND KNOW THE SAME TO RE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR TI4E PERFORMANCE OF CONSTRUCTION. <br />/� <br />/ <br />X <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />WATER HEATERS -ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />1 <br />I <br />SUBTOTAL <br />PERMIT <br />$ O <br />TOTAL FEE <br />WATER <br />SERVICE SIZE III BLDG. SUPPLY <br />SIZE 11 <br />SI NATU E 04CONT-P(APIORORAOUTH, AGENT TE -7 <br />SIDE YARD SETBACK <br />s��' <br />STREETSETBACK <br />ZdT-- <br />REAR YARD SETBACK <br />-ZOO <br />PLnNC CK UMBER <br />�J / <br />/ //O� -0 <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />2�3 <br />LOT AREA <br />VACANT 31TE <br />❑YES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO. <br />UNITS <br />OF DWELLING <br />— <br />T <br />BUILDING <br />§, wc�m <br />SIZE OF BLDG. <br />3oONE <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />_ <br />FIRE ZONE <br />3 <br />BASEMENT REOUI <br />►�Q q <br />ED LERS <br />❑YESED nrvO <br />^HANICAL <br />ga I O (� <br />SPECIAL CONDITIONS'. <br />OTHER <br />PENALTY <br />SEC. 000 (a) <br />I <br />TOTAL <br />3Z ' <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN TI4IS SPACE) TI41S IS YOUR PERMIT <br />Cn <br />N <br />N <br />AMLICATIBN ALtiEP1LU 6Y. <br />PLANS 111FCKlB aY'. AWBpVlO <br />F00ISAIANCC pY <br />1�1I LE <br />