Laserfiche WebLink
�he Evergreen <br />�iT� �F <br />everett <br />CITY MALL 25}B7d5 <br />'� �CONSTRUCTIO� <br />PERIVIIT <br />� <br />PERMIT N0. � 4 � l <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING {Y� MECHANICAL ❑ PLUMBING <br />OWNER MAI�ADDPE55 CIN ZIP PHONE <br />Elvira Powell 2011 19th Street Everett 98201 <br />ARCMITECT OR DESIGNER MAIL ADDRE55 CITV ZIP PHONE <br />GENERAL WNiRACTOH MRIL ADDRE55 QTY ZIP PHONE UCENSE � <br />MECHANICAL LONTRACTOR MAIL ADDflE55 CITY ZIP PHONE LICENSE Y <br />Natural Gas Equipment 1625 East Marine View Drive Everett 98201 258-2441 <br />PLUMBING CUNTRACTOR MAIL A��RESS GITV ZIP PHONE LICENSE I <br />CL15$ OF WORK <br />❑ NEW ❑ ADDI710N O ALTERA710N ❑ REPAIR ❑ DEMOLI710N O FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />s <br />DESCR'BE WOFiR <br />LOT_B�OCK_OF <br />JOB ADDRE55 <br />2011 19th Street <br />PLUMBING <br />NO. TYFE OF FIXTURE OR ITEM <br />BATHTUB <br />LAVA"1'ORV�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />UFINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKEFiS <br />ROOF DRAINS — RAINLEAOERS <br />SINK (SERVICE — BAR, ETC.) <br />FEE <br />SUB TOTAL f <br />PERMIT f <br />TOTAL FEE S <br />IEE7 SE7BACK REAR YAFiD S <br />' AREA VACANT SITE <br />.�.YES :-NO <br />:UPANCYGROUP Nq.OFOWEL <br />SI2E Of h�D3. NO. OF S70RIES <br />FIRE ZONE BASEMENT <br />APPROVALS <br />1. ENVIRONMEN7AL CHECK LIST <br />2. BUILOING PLANS <br />3. FIRE HYDRANT <br />d. FIRE PROTECTION SYSTEM <br />5. GRA�ING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPAC75ThTEMENT <br />B. HEALTH DISTFICT <br />APPLICATION ACC. 8Y PLANS CHECK <br />MA%.00C.LOAD <br />FIRE SPRINKLER: <br />REOUIRED <br />YES NO <br />BY UA' <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 8E 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 REGULATIN� CONSTRUCTION OR THE <br />PERF�/�yCE OF CONSTRUCTION. <br />SIuNA1URE Q6KO�TOR O9 FyTyOR12EU AGENT DATE <br />X ��.0 i �u�, _ <br />MECHANICAL <br />N0. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />RE�FI�ERATION UNITS — H.P. EA. <br />DOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FOFGED AIR SVSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />1 UNIT HEATERS — B.7.U. M <br />EVAPOFATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />FANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />SUB TOTAL S 8 <br />PERMIT S 10 <br />TOTAL FEE f <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />FEES VALUATION FEE <br />BUIL�ING S <br />PLUMBING <br />MECHANICAL� 1H <br />O7HER <br />PENALTY <br />U.B.G. <br />SEC.303 <br />TOTAL I I 18 I00 <br />PEHMIT VALIDATION <br />WHEN PROPERLY VALIDA7ED (IN THIS SPACE) THIS ISNqUji PEFMIT � <br />� �� i i . — Ci" <br />� <br />�' <br />; i I � <br />ADDRESS FILE <br />