Laserfiche WebLink
I <br />the EYBrpmB <br />CITY OF <br />everett <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT.WA98201 OCCEMBINATION <br />-`PLICATION FOR <br />CONISTRUCTION <br />PERMIT <br />LDING ❑MECHANICAL ❑PLUMBING PERMIT NO. <br />eVlPtD <br />ARCHITECT OR DESIGNER <br />CENTRAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF <br />_ _ 3 , _ _ ,_, lwi / 17-7-7dU/, dirlNVJl1fib <br />LICENSE 1 <br />PIUMBING CONTRACTOR MAIL ADDRESS <br />CITY ZIP PHDNF LICENSE F <br />rCLASS OF WORK '( <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE �ySIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION Of WORK <br />F-Ooo� <br />OfSCRIB! WORK �/` <br />Installation 0 <br />CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PROPOSED USE Of BUILDING I <br />HEREBY <br />AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PLICATION <br />OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />IFGAI DESCRIPTION OF PROPERLYISHON'N BELOW OR ATTACH IOURCOPI[SI PROVISIONS <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />LOT �BLOCK��Of <br />TO VIOLATE OR CANCEL THE PROVISIONS OF <br />GIVE AUTHORITY <br />ANY OTHE ST6TE OR LOCAL LAW 5EGULATING CONSTRUCTION <br />OR THE P F OF CO XRLCTION. <br />DATE <br />SIGNATUft <br />OF OR R A L ED AGENT <br />) <br />IOB AnoalQ� /� l,e <br />ME <br />�ANICAL <br />PLUMBING <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />NO. TYPE OF FIXTURE <br />AIR UNITS-H.P. EA <br />WATER CLOSET (TOl1ET1 <br />REFRIGERIGER ATION UNITS-M.P. EA <br />BATHTUB <br />BOILERS -HP EA . <br />LAVATORY (WASH BASIN) <br />GAS FIRED A C. UNITS -TONNAGE EA <br />SHOWER <br />FORCED AI0. SYSTEMS-B.T.0 M EA <br />KITCHEN SINK IS OISP <br />WAIL HEATERS-BT.U. M <br />DISWASHER <br />UNIT HEATER$ -BTU M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />CLOTHES DRYERS <br />WATER NEATER <br />VE Ni1lAT10N FAN <br />URINAL <br />DRINKING FOUNTAIN <br />RANGE MOOD <br />AIR HANDLING UNIT - <br />STOVE <br />VACUUM BREAKERS <br />METANEY <br />L FIREPLACE 8 CHIM <br />ROOF DRAINS- RAINLEADERS <br />SINK (SERVICE -BAR. ETC) <br />SUBTOTAL <br />S <br />B <br />SUB TOTAL <br />PERMIT <br />PERMIT <br />S <br />TOTAL <br />FEE B <br />TOTAL FEE <br />IT <br />S <br />YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />RECEIPT NO, <br />FEE <br />LOT <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />OYES ONO <br />OCCGROUP NO. <br />OF DWELLING UNITS <br />BUILDING <br />S <br />// 77 <br />C1J <br />�A�pp <br />V� <br />alTBACKSTREjllTHACjK'jORo0'S <br />NO RIES <br />MAX OCC LOADPIUMBING <br />BAS <br />REQUIRED TIRE INKLf SPRINKLERS <br />MECHANICAL <br />OYES ONO <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />T ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC. <br /><EC. 703(a) <br />2. BUILDING PLANS <br />TOTAL <br />!_3 <br />VJ <br />T FIRE HYDRANT <br />4 FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS IS YOUR PERMIT <br />f, <br />5 GRADINGIEKCAVATION 6 CLEARINGIGKLIBBING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />B HEALTH DISTRICT <br />APPLICATION ACC BY P N E ED B <br />APPR FOR ISSUANCE BY <br />To i y5U/>NCE G'— 1,9—_- e-7, iY <br />9.1.79 .tiv 2pcaTdl) Awl— <br />