Laserfiche WebLink
the Evergreen <br /> CITY OF CONSTRUCTION evere" <br /> everett PERMIT <br /> CITY HALT. 155 B11I1 <br /> EVI NI I- 14SHINGTOM <br /> 1111101 <br /> UPI Of COMMUNITY BUILDING MECI-I ANI rAL PLUMBING �e <br /> OFY[10E4FN1 <br /> OWNER -- MAIL ADOIILIL Y, ,I, Ni <br /> � mrBm -&d �U <br /> ANIR DESIGNER MAIL ADDRESS . <br /> LLYI�ON7VM;7 Lt`LNO. <br /> GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> (Y <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. W <br /> Go <br /> PERMIT CLASS OF WORK � <br /> Z <br /> BUILDING ❑PLUMBING ❑MECHANICAL ~ <br /> ❑NEW ❑ADDITION `ALTERATION ❑REPAIR � <br /> VALUATION OF WORK 2 <br /> ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL w <br /> a <br /> s <br /> DESC�RIByC WORK <br /> _uy.•r• ����44By,N� 214 <br /> Ama MCI fogave <br /> PROPOSED USE MECHANICAL _ <br /> TYPE OF FUEL OIL ❑OAS <br /> COPIES) <br /> • LPG. ELEC. <br /> LOUR CSE DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br /> NO. TYPE OF EQUIPMENT FEE <br /> LOT.— CLOCK—OF AIR COND.UNITS-H.P.EA. S I <br /> �J try er� a CIM J� IV at� REFRIGERATION UNITS-11.P.EA. <br /> W' QifR I_ Vi Imo" BOILERS-H.P, EA. I <br /> jet � -- - GAS FIRED A.C.UNITS-TONNAGE A. <br /> _ FORCED AIR SVSTE MS-B.T.U. MEA. 1 <br /> JOB ADDRESS / WALL HEATERS -B.T.U. M <br /> �l [ � UNIT HEATERS-B.T.U. M I <br /> �V EVAPORATIVE COOLERS <br /> PLUMBING CLOTHES DRYERS I <br /> -- VENTILATION FAN <br /> RANGE HOOD I <br /> NO. TYPE OF FIXTURE OR ITEM FEE AIR MENACING UNIT- C.F.M. <br /> INCINERATOR 1 <br /> WATER CLOSET(TOILET) S <br /> BATHTUB <br /> LAVATORY(WASH BASIN) <br /> SHOWER <br /> KITCHEN SINK&DISP. SUBTOTAL S I <br /> DISHWASHER PERMIT S <br /> LAUNDRY TRAY TOTALFEE f I <br /> CLOTHES WASHER THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br /> WATER HEATER TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF <br /> URINAL CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br /> PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br /> DRINKING FOUNTAIN <br /> FLOOR-SINK OR DRAIN I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> VACUUM BREAKERS PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> ROOF DRAINS-RAINLEADERS OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> SINK (SERVICE--BAR ETC.) 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 /> SUBTOTAL <br /> PERMIT f <br /> TOTALFEE S <br /> X <br /> SIGNATURE OF CONT RACTOR OR AUTM.AGENT DATE <br /> SIDE YARD SETBACK STREET SETBACK REAR YAROSETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> []YES ONO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP UNi05 DWELLINGf_/�f <br /> 612E OF BLDG. NO.OF STORIES MAX.OCC. LOAD BUILDING f _M <br /> PLUMBING <br /> FIRE ONE BAS T IR INKL R6 - <br /> RCOUIREO <br /> VES ONO MECHANICAL I <br /> ❑ <br /> SPECIAL CONDITIONS: OTHER <br /> I <br /> T <br /> PENELTY SEC.303(a) I <br /> 1 <br /> TOTAL s b0 <br /> —' PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IL YOUR PERMIT <br /> MPLICAT12y ACLVIED BY PLBNS�[MEU BY BPPBOYIO D SSUPNCI BY. <br /> ROM& <br /> 0 <br />