Laserfiche WebLink
du� Ererxreen <br />CITV OF <br />�verett <br />CITY HALL 259�8745 <br />�_._. __ CaN <br />STRUCTIC��I <br />PERMI� <br />PERMIT NO. �3786 <br />�� �VERETT,WA98201 ❑ COMBINATION �X' BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MFILApOPE55 CITY Zlf' PMONE <br />DAVID BRANDVOLD BOX 3066 EVERETT lJA 98203 35�_G_000 _ <br />ARCMREGT OR OE513NER MAII AppFESS CITY 21P PHONE <br />INPRESSION DESIGN 2229 JACKSON EVRETT lVA 98203 355-3�00 <br />GENERAL CONTRACTOR MAII. ADDRE55 GTY ZIP PHONE LICENSE X <br />D. A. BRANDVOLD <br />MECMFNICAL CONTRACTOR MAIL ADOPESS CRY ZIP PHONE LICENSE M <br />PLUMBING CONTRACTOR MAIL PODflE55 CIiY ZIP PMONE LICENSE N <br />CLA55 OF WORK <br />❑ NEW O ADDITION X�eI ALTERATIOtJ ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WO00 STOVEIFI'iEPLACE INSER7 <br />VALUATION OF WOflK <br />5 450. �0 <br />Construct floor to ceiling 2x4 wall <br />OSED USE OF BU'LDING <br />Storaqe of video machines <br />LOT <br />JOB A�DFE55 <br />7600 Evergreen <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />W ATER C�OSET (TOI LEn <br />BATHTUB <br />LA4ATORY(WASH BASIN) <br />SHOWER <br />KITGHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATEFi HEA7ER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADER.i <br />SINK (SERVICE — BAFi, ETC.) <br />SU�70TAL <br />PEflM17 <br />TOTAL FEE <br />1. ENVIRONMENTAL CHEGK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIfiE PROTECTION SYS7EM <br />5. GRAOING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTA7EMENT <br />8. HEALTH OISTRICT <br />nPPLICATION ACC. BY PLANS CHE <br />COPIES� <br />I HEREBY CERTIFY T�IAf I HAVE READ A"JD 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 �NILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PEHMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR ¢ANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />60CWL LANLPEGULATING CONSTRUCTION OR THE <br />AGENT OATE <br />FEE N0. TYPE OP E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EF. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAP�RATIVE COOLEHS <br />CLOTHES DRYERS <br />VENTILATIOIJ FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.P.M. <br />STOVE — WCOD <br />METAL FIREPLACL 8 CHIN,NEV <br />FIRFPLACEINSERT <br />HEAT PUMP <br />� <br />S <br />S <br />REAR YARD SETBACK <br />VACANT SITE <br />�-:YES :-.NO <br />NO. OF DWELLING UNITS <br />MA%. OCQ LOAD <br />FIRE SPRIIJKLERS <br />RE�UIREU <br />'.:_YES : NO <br />BY DA7E <br />APPR. FOR <br />SUB TO7AL 5 <br />PERMIT S <br />TOTAL FEE 5 <br />84/13786 I FEE6. 5O �I, �/,�� EIPT NO. <br />FEES VALUATION I FEE <br />BUILDING S <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY � <br />?OTAL I I Z� � Q� <br />PERMIT VALI�ATION <br />WHEN PROPERLY VALI�ATED �1N THIS SPA�E) THIS�IS�YOyR PERti117 (�� <br />�. , : ,, / 1. . � 1 GG <br />��RN��X Dauble permit fee <br />N- <br />C.";' <br />- . .._... i� I �-� <br />ADDRESS fILL' <br />� <br />� <br />z <br />0 <br />� <br />r-� <br />c� <br />m <br />�� <br />.. --i <br />tim <br />O <br />C O <br />mo <br />n <br />--� c <br />O 3 <br />m <br />-i z <br />x -� <br />m <br />�. <br />.CJ 2 <br />n -i <br />rx <br />—I N <br />� <br />� <br />O D <br />3 <br />-i m <br />S <br />m� <br />�� <br />r, <br />om <br />C N <br />3 N <br />Z C� <br />� ^ <br />> <br />A <br />�--I <br />2 <br />n <br />z <br />--i <br />2 <br />i--i <br />N <br />z <br />O <br />.�-. <br />('� <br />m <br />� <br />