Laserfiche WebLink
The Ei,ergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 ❑ COMBINATION <br />;ONSTRUCTIOV <br />PERMIT <br />❑ BUILDING iz MECHANICAL <br />PERMIT NO. 15186 <br />El PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />James Klicpaera 5026 27th Avenue West Everett 98204 353-7779 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A' <br />G.A.S. Inc. 1103 North 36th Seattle 98103 632-5000 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N <br />GASAPL371NT <br />CLASS OF WORK <br />❑ NEW [I ADDITION 0 ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN O WOOD STOVEIFIREF'LACE INSERT <br />VALUATION OF WORK <br />DESCRIBE WORK <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT, ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <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 R LA TING CONSTRUCTION OR THE <br />PERF0R CONSTRUCTION. <br />SIGNATUR TR t UTH ED AGENT DATE <br />X / 7/22/85 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />LOT_BLOCK_OF <br />JOB ADDRESS <br />5026 27th Avenue f-.est <br />PLUMBING <br />ME ANICAL <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 />_ <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 & DISP. <br />1 <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />7 <br />50 <br />DISHWASHER <br />WALL HEATERS — B.T.U. Ni <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />— <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 — W000 <br />ROOF DRAINS — REM <br />METAL FIREPLACE 8 CHIMNEY <br />SINKS`-RVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />1 <br />Water Heater <br />4 <br />50 <br />1 <br />1 Piping <br />2 <br />00 <br />SUBTOTAL <br />51 <br />SUB TOTAL $ <br />14 <br />00 <br />PERMIT <br />f <br />PERMIT $ <br />in <br />On <br />TOTAL FEE <br />5 <br />TOTAL FEE $ <br />24 <br />00 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />RZAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />$ <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />DYES ❑NO <br />MECHANICAL <br />24 <br />00 <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 />24 <br />00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED 'IN THIS SPACE) THIS IS YOUR PERMIT (G <br />OC <br />T' <br />Lr <br />T <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTRICT <br />APPLICATION ACC. <br />TP�ANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />ADDRESS FILE <br />