Laserfiche WebLink
fAP Evlrgw,F R <br />CITY OF <br />everett <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 ❑COMBINATION <br />LJNSTRUCTIO <br />PERMIT <br />❑ BUILDING ❑ MECHANICAL <br />❑PLUMRING PERMIT NO. <br />u <br />GINIRAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Pit MBING CONTRACTOR Wit ADDRESS CITY ZIP PHONE LICENSE <br />CLASS Of WORK <br />❑NEW ❑ADDITION ❑ALTERATION REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />DESCRIBE WORK <br />rlloroslDusE DI BUILDING <br />I HEREBY CERTIFY (HAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE 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 AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />x >, , <br />LEGAL DIISCRIPTTON OF PRONRTY (SHOWN SHOW OR ATTACH FOUR COPIES) <br />Loy L III Ock�OF. /a T O% P, IV/e fl <br />t, / - z-n-zr <br />D ,oG 2 TN T <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATERCLOSET(TOLIET) <br />AIR COND UNITS —HP [A <br />BATHTUB <br />RIFRIGERATIONUNITS—HP EA <br />LAVATORY (WASH BASIN) <br />BOILERS-H P [A <br />SHOWER <br />GAS FIRED AC UNITS -TONNAGE EA <br />KITCHEN SINK 6 DISP <br />FORCED AIR SYSTEMS-B T U MIA <br />DISWASHIR <br />WALL HEATERS-0 T U M <br />LAUNDRY TRAY <br />UNIT HEATERS-B T U M <br />CLOTHES WASHER <br />IV'APORATIVI COOLERS <br />CLOTHES DRYIRS <br />WATER NEATER <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT- CFM <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS-RAINLEADERS <br />MF1AL FIREPLACE B CHIMNEY <br />SINK (SIRVICI-BAR. ETC) <br />SUBTOTAL <br />$US TOTAL { <br />PERMIT { <br />PERMIT { <br />_ <br />TOTAL FEF 51 <br />TOTAL <br />FEE { <br />SIDE YARD St /BACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FL[ <br />RECEIPT NO <br />USE ZON! <br />' rf OF CONST <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />Fit <br />OCCUPANCY GROUP <br />NO OF CWELLING UNITS <br />BUILDING <br />0 <br />SIZI OF BEING <br />NO OF STORIES <br />MAX OCC IOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENI <br />HI DRLX)MS <br />IIRI SPRINKLERS <br />RIQUIRID <br />❑YTS ONO <br />MICHANICAI <br />A►PBOVAIS <br />BY <br />DATE <br />OTHER <br />1 INVIRONMENTAL CHECKLIST <br />PENALTY <br />SEC X) <br />SEC XRI <br />BUILDING PLANS <br />L FIRE HYDRANT <br />TOTAL <br />3 <br />�d <br />A )IRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHIN PROPERLY VAIIDAIE D TIN THIS SPACE) THIS IS YOUR PERMIT <br />S GRADINGII XCAVATION 6 Cl i ARINGICRUBRING <br />6 DRAINAGE <br />7 ENVIRONMENTAL IMPACT SIAI[M[N1 <br />B HEALTH DISTRICT <br />APPLICATION ACC BY <br />►TANS CHl CkFO BY <br />^rrR nIP iSSL.ANCI BY <br />91.79 <br />