Laserfiche WebLink
the Evergreen CITY OF F CO'' STR U CTIO N <br />CITY <br />everett PERMIT PERMIT NO.06581 <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 ❑ COMBINATION (x BUILDING Ll MECHANICAL I I PLUMBING <br />OWNER MAIL AUUTA S, ,I, IiP PHONE <br />Robert D. Sebers 615 75th Street N83D 98203 353-3266 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY SIP PHONE LCENSE F <br />CLASS OF WORK <br />❑NEW ❑ADDITION 22ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN COARAGE <br />VALUATION Of K <br />s 4,000.00 <br />DESCRIBE WORK <br />Converting from single family to duplex <br />PROPOSED USE OF BUILDING <br />Two family unit <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 />HEREIN OR 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 />CON RUCTION OR THE PERFORMANCE OF CONSTRUCTION <br />S ATURE F CONTRA T7UTHOf4D AGENT DATE <br />1292XXY 8/22J <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIESI <br />LOT �OF 11 —Beverly Home Tracts Div. 2 <br />LOT —BLOCK. —OF <br />JOB ADDRESS <br />9i5X198KX!{8 601 75th Street S.E. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE _ <br />1 <br />WATER CLOSET (TOILET) <br />AIR COND UNITS - H P. EA <br />_ <br />1 <br />BATHTUB <br />2 <br />00 <br />REFRIGERATION UNITS - H P EA <br />• <br />LAVATORY ASH BASIN <br />2 <br />00 <br />1 <br />BOILERS - H.P. EA. <br />PHOWER <br />GAS FIRED N C. UNITS -TONNAGE EA. <br />_ <br />KITCHEN SINK 8 DISP. <br />FORCED AIR SYSTEMS -BTU M EA <br />DISHWASHER <br />WALL HEATERS -BT.U. M <br />_ <br />_ <br />LAUNDRY TRAY <br />UNIT HEATERS - D.T.U. M <br />_ <br />CLOTHES WASHER <br />2 <br />00 <br />1 EVAPORATIVE COOLERS <br />1 <br />_ <br />WATER HEATER <br />2 <br />00 <br />1 <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />1 <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C F M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RANLEADERS <br />METAL FIREPLACE 6 CHIMNEY <br />_ <br />SINK (SERVICE - BAR. ETC) <br />BUD TOTAL <br />SUB TOTAL 4 <br />6 <br />00 <br />PERMIT f <br />PERMIT f <br />OTAL FEE IF <br />12 <br />00 <br />TAL FEE t <br />6 <br />00 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT N0. <br />USE ZONE <br />R-3 <br />LOT AREA <br />VACANT T�FS��I�TVE1 <br />DYES <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />2 <br />BUILDING <br />s 4,000.00 <br />23 <br />00 <br />SIZE OF BLDG <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />PLUMBING <br />12 <br />00 <br />FIRE ZONE <br />3 <br />BASEMENT <br />yea <br />FIRE SPRINKLERS <br />�YESIRL <br />MECHANICAL <br />6 <br />00 <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHF�K LIST <br />PENALTY <br />SEC C.(BI <br />2. BUILDING PLANS <br />TOTAL <br />46 <br />--- <br />00 <br />3 FIRE HYDRANT V4 <br />4, FIRE PFIO ION SYSTEM <br />V5 GPAM <br />PERMIT <br />DA�TED„IIIS 6P'`IIS YO �� <br />VALIDATION • <br />.0V <br />WHEN+pPEZYYcc <br />cc <br />OUR RCCEIPX i6uR RECEIPtc-' <br />THANK YOU rk"K Y O U �- <br />t <br />S DRAIAAGW go <br />7. ENVIkNMJdTAL III STATEMEN' <br />Q8 HEALT RICT <br />APPLIC Ti� . BY 429 <br />C <br />MANS CHECKED BY <br />V.C. <br />-APPR. FOR ISSUANCE BY <br />G <br />