Laserfiche WebLink
tMEwrpn�n APPLICATION FOR <br />°�TM°F �;ONSTRUCTION <br />everett PE RM IT <br />DEPT OF COMMUN�TV DEVELOPMENT SERVICE$ <br />CITY HALL 259-8745 <br />EVERETT, WA98201 ��OMBINATION ❑ BUILDING <br />ARCHITECT <br />lYHNI <br />e <br />❑ MECHANICAL ❑ PLUMBING PERMIT NO. <br />CITY ZIP PMONE <br />-Sd = ��•, n�' ��f,7o1 �saz-Y9�)� <br />GENFNAI CONIN�CipR M�IL �DDNE55 CIiY ZIP PHONf UCFNSE 1 <br />h�F[HnNICyL CONTR�CTpp MML ADDRF55 CITY LIP PHONF �I[ENSE / <br />v1UMPING CONLR�CTOR MAII �DONE55 UTY ZIP PHONE IICEN$E I <br />CLA55OF WORK <br />�NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑�EMOLI7ION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />\'�WAIIONOf WORR <br />t <br />�k5[RiHF/WOPlK <br />W n.� t ci 3�d ��e <br />veovosm us� a xwioiHc <br />IFCAI �l$CHIPiIOu O( PNOPfRiY �SHON'N flELOW OR AiTACN iOUR COP16) <br />l01 BLOCK�Of <br />ION ADORISS '7 <br />.� � S ' .5 � %• <br />PLUMBING <br />NO. TYPE OF FII <br />WATER CLOSET ITOUfTI <br />BATHTUP <br />UVATORV �WASH BASIN) <br />SHOWtR <br />NIiCHEN SINK 8 DISP <br />DISWASHFR <br />UUN�RY TNAV <br />CLOTHES W�SHEN <br />URINAL <br />ORINKING FOUNTAIN <br />FLOON DRAIN <br />\'ANUM HREAKERS <br />ROOf DRAINS—RAINLEAD <br />SIr�K 6FRVKE—b�k. tTC 1 <br />USE ZOuf <br />TYPL OF CONST <br />RHE ZO"11 <br />FEE <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 />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTINr OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION$ OF <br />ANY OTHER STATE OR LOGL LAW REC�JLATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTHACTOR Oft AUTHORIZED AGENT DATE <br />MECHANIC.IL <br />NO. TYPE OF EQU <br />AIR COND IJNITS—N P. EA <br />REFRIGERATION UNITS—H. <br />1l iEE f <br />SCTflACK RUR YARD Sf T9ACK PUN <br />l0T ARf A <br />OF STORIE$ <br />M��OVAtf <br />1 ENVIRONMENTAI CHECK LIST <br />2. PVIL�ING PlANS <br />7 FIMF HYDNANT <br />< FlBE PROT[CTION SYSTEM <br />5 CNADINGifXUVATIONbCLfARINGICRUBNING <br />6 DRAINAGE <br />7 ENVIRONMfNTAI IMPACT ST�TEMENT <br />B HFALTH DISTRICT <br />VACANTSRE <br />❑YE$ ❑NO <br />NO O( DWELIINC l <br />MA% OCC.IOAD <br />FIRf SPNINKLfRS <br />RFQU�RfO <br />❑YFS ❑NO <br />!Y DAiE <br />APPlICA7lON AQ. BY PLANS CHECKED BY I APP0. f00. ISSUANCE BY <br />9-1 79 <br />BOIlEkS—MP EA <br />GA$ FlRED AC. UNITS-70NNACE FA <br />FONCED AIH $YSTEM$—BS U. M <br />WALIMEAiERS—BTL M <br />UNITHEA.'ERS—BTU M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR MANDLIN(; UNIT— C F M. <br />ME1AL FIREPLACE 6 CHIMNEY <br />FEE <br />SUt TOiAI f <br />rE�MIT f <br />TOTAL FEE f <br />PLAN CMECK FEE <br />FEF RECEIPT NO. <br />VALUA710N il <br />dUILDINC f <br />YWMOING <br />MECMANIUI <br />OTMEN <br />PENALTY U.B.C. <br />SEC 301�a) <br />TOiAI <br />�ERMIT VALID�710N <br />WHEN PROPERLY VALIDATEO (IN THIS SPACfI THIS IS YOl1R PERMIT <br />_� <br />