Laserfiche WebLink
'7/lE•[L'C TO <br />CITYY OFF V CONSTRUCTI�gN _ <br />' <br />everett PERMIT <br />CITY HALL 259-R745 <br />EVERETT WA 9020T ❑ COMBINATION I B <br />WILDING MICHANICAL 1 1 PLUMBING <br />OWNER <br />. Ali(JryTEC70R Dk$�TIIR <br />MAIL A��SS <br />PIIGNE <br />k NLRAL CON1=C104 <br />/ <br />FA•�- <br />MAIL ADDRESS <br />-- --"-"� <br />1, P-111E <br />LK.E115L r <br />Mt[;HANI^� CANiRAC70R <br />MAIL ADORLSS I <br />(,Itr <br />lIP PHONE <br />UCf N5EI, <br />PLUMBING iRAC10R <br />MAIL DflE 55 <br />Lot <br />11P <br />— <br />P NL <br />L CNSk <br />❑NEW ❑ADDITION ❑ALTERATION RtPAIR L]DEMOLITION LFENCE LSIGN I_IOARAGE <br />VALUATION OF WOW( <br />DESCRIBE WORK <br />IWOP05ED USE OF WILDING V <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HERLIN ON NOT THE GRANTING OF A PERMIT DOES NOT <br />,PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONST 'TION THE PERFORMANCE OF CONSTRUCTION. <br />S1t•gA WI U1 e.relf;fpo •:n -.-U l.I RI; DATE <br />T, <br />LIGAI DISC lit 110NOFPROPERTYSHOW BELOW OR ATTACHFOUR4IIIIIESI <br />OT Dlac_oF ^ L j. i «/ 2 ii F <br />' <br />(i�r - 7G• /�) f% �sFi lF S 4 s i; 33/ T nF Ej s" <br />G1—O <br />J)r OU �/' Z&.S,s ,(,'F� E72/� _ ' � <br />JOB ADDRESS <br />9 L <br />PLUMBING <br />NO. <br />MEC <br />ANICAL <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYP[ OF EOUIPMENT <br />FEE <br />WATER CLOSET ROILET) <br />_ <br />AIR - <br />III I PoI.''. (� II F.n <br />110II I IC. -- <br />GA"''I _TONNA.Gf. F% <br />FORT I I (T I q M FA <br />--- --- <br />1YAllnl'I- <br />BATHTUB <br />LAVATORY ASH BASIN) <br />— <br />SHOWER <br />KITCHEN SINK WISP <br />DISHWASHER <br />LAUNDRY TRAY <br />UNIT HLAItgS U IA <br />CLOTHES WASHER <br />1 VAI L)RATIVL L, --- <br />WATER HEATER <br />CLUllll S UiIYI. <br />URINAL <br />V1LIR,1IIO' AN <br />DRINKIN UNTAIN <br />RANL'- J )D <br />FLOC) DRAIN <br />AIR HANDLING UNIT -- C F LI <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />TAL I IRE PI ACE R CHIMNEY <br />SINK (SERVICE — BAR. ETC! <br />' <br />SUB TOTAL <br />SUB TOTAL f <br />PERMIT f--- <br />PERMIT s <br />SIDE 1ARU SETRACK <br />TOTAL FEE <br />S7RELT SETRACK <br />f <br />REAR YARD SE iBACK <br />TOTAL <br />PLAT) CHECK tJIIMBEN <br />FEE f <br />PLAN CHECK FEE <br />f EL RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ❑NC <br />PEES <br />VALUATION <br />FEE <br />TYPE OF CONST, <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />I <br />SIZE OF BLDG <br />ND. OF STORIES <br />MAX OCC. LOAD <br />PLUMBING <br />I IRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />(TYES [!NO <br />MECHANICAi. <br />_ <br />APPROVALS <br />BY <br />DATE <br />----- <br />--- <br />I ENVIRONMENTAL CHLCK LIST <br />BUILDING PLANS <br />PENAL fY <br />_ <br />U B C <br />S[C 3r17 (a) <br />_ <br />1 FIRE HYDRANT <br />TOTAL <br />A FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WIILN P40Pf ILLY VALIOA71:1) TIN III(.-, fl,mj I lm1 IS POUR I'LIIMIT <br />" GRADING <br />I" DRAINAGE <br />F ENVIRONMENTAL IMPACT STAIEMENT <br />a HEALTH DISTRICT <br />APPLICATION ACC TBYPLANS <br />CHECKED BY <br />APPR FOR ISSUANCE HY <br />