Laserfiche WebLink
TAR E:Y.IyFBBn A P O C A T I O N FOR'= <br />CITY OF LONSTRUCTION <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />'VEREIT, WA9R201 ❑COMBINATION ❑ BUILDINC ❑MECHANICAL ❑PL.UMBING PERMIT NO. <br />OWNF( MAILAUDRISS Cl" ZIP PHONE <br />cL& rt <br />CITY <br />GENERALCONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF <br />�Z &)ID0 h0ACSTktlIIt!, ELY,z•t- 0?,�a03 Rc.oFR9�24/i�% <br />ADDRESS <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK � <br />❑NEW ❑ADDITION ❑ALTERANON UREPAIR ❑DEMOLITION ❑FENC'E ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION OF WORK <br />DI SCRIBE WORK <br />1-)i7):0� . ��9LI /a a'S /1k�Cl�•:./.19 �E3 ��E S <br />PROP06O USF 01 flUIIDING <br />l I[s I <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW 1 HE 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 PRESUME TO <br />GIVE ITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER OS7ATE R LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />7 / <br />' � � G y/�rC l� <br />�I�. <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TOUR COPIESI <br />LOT _BLOCK —Of <br />. 3 Lk �L' s) li Z F-C (I) j <br />cGLox AooREss � <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET(TOLIET) <br />AIR COND UNITS —HP EA <br />BATHTUB <br />REFRIGERATION UNITS—H.P FA <br />LAVATORY (WASH BASIN) <br />BOILERS—H P EA <br />SHOWER <br />CAS FIRED AC UNITS —TONNAGE EA <br />KITCHEN SINK 6 DISP <br />FORCED AIR SYSTEMS-8 T U M EA <br />DISWASHER <br />WALL HEATERS—B.T U M <br />LAUNDRY TRAY <br />UNIT HEATERS-0 T U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <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 <br />ROOF DRAINS—RAINLEADERS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE —BAR, ETC I <br />SUBTOTAL <br />SUBTOTAL S <br />PERMIT <br />S <br />PERMIT S <br />TOTAL FEE <br />S <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHE K NUMBER <br />f �K <br />XV <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 />VAIUAYION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />"?soon <br />OS <br />O <br />!,'c <br />, <br />SIZE OF BLDG <br />N' OF STORIES <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />BEDROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />❑YES ❑NO <br />MECHANICAL <br />AP►ROVAL$ <br />BY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC. <br />SEC 303(a) <br />2 BUILDING PLANS <br />TOTAL <br />J Lp, <br />Zj <br />FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />5 GRADING/1 %CAVA710N6 CLFARINGILRUBBINC <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKFD BY <br />APPR FOR ISSUANCE BY <br />9.179 <br />