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!hc fvcrgrceir <br /> ��r� �� CONSTRUCTION everett <br /> �everett PERMIT <br /> CI�Y N411 )1VBA1' <br /> IVIxfIi µ45NING'inl <br /> �x�m <br /> ;,�P, IIIfI1MMUNIfY BUILDING MECHANICAL PLUMBING <br /> UEVLlOYMIN� <br /> OWNyFR� M MAIIADOHESS y �Z}�IP [ YHONE <br /> M"� � RI � � �w ��K7 �� <br /> ARCHITECT OR DESICNER MAIL AOORESS PMONE LICENSE NO. <br /> � � � � � �1 � �� <br /> GE`NERAL CONTRACTOR MAIL ADORC55 PHONE LICEN!:E NO. <br /> M �� <br /> MECMANICALCONTRACTOR MAII.AD[JRESS PHONE LICENSE NO. <br /> � �'�r3:��i <br /> PLUMOING CON♦TRACTOR MAIL AC)DRESS PHONE L 'ENSE NO. � <br /> ,1 i�K����W m <br /> PERMIT CLl15u OF WORK j <br /> �UILDING �PLUM6ING �M6CHANICAL Z <br /> �NEW []ADOITION ❑ALTENATION ❑REPAIR ~ <br /> _ � <br /> VALUATION Oi WORK � <br /> s �/Yyi/r� ❑OEMOLISH ❑FENCE ❑SIGN ❑SWIIAMINf POOL W <br /> wwwov <br /> a <br /> DESCRIBE WORK — <br /> O�� mr d�l,e � ��w�tl� �8 4 <br /> PROPOSEO USE �� <br /> �� � �'�� MECHANICAL <br /> TVPEOFFUEL �OIL QNAT. �LPG. ELEC. <br /> LEGAL DESCRIPTION OF PROPENTv �SMOW OEIOW OR niTACH GAS <br /> FOUN iE51 <br /> � � TS� � NO. TVVE OF E�UIPMENT FEE <br /> LOT BLOCK_OF- _ __ __ — _ <br /> AIR CONO. UNITS-�N.P. EA. 5 I <br /> � p � _ R[FRIGERATION UNITS: H_P. EA _ —r <br /> - -- — hU1LER5-H.P. EA. I <br /> GAS FINEO A.C. UNITS-iJNNGGE I:A. <br /> FOHCED AIR SYSTBMS� O.T.U. M EA. � <br /> J09 AO�RE55 WqLI I�EATERS�-H.T.U. M <br /> � � � UNII� NEATERS-9.T.U. M I <br /> EV<.PORAiIV'CUOLIJiS <br /> PLUMBIMG - — CLpTHES DRVERS � <br /> VENTILATION FAN —�— <br /> AANGENOOO � <br /> TVPE OF FIXTURE OR ITEM F'E AIR NANDLING UNIT- _ C.F.M. <br /> WATER•CLOSETITOILETI __ s INCINERATOR __ � <br /> BATI ITUB <br /> — _I <br /> LAVATORVIWASMBASINI � <br /> SHpWER - — <br /> KITCHEN SINK h OISP. SUB lOTA� S <br /> -' I <br /> �ISHWASHEP VERMI'.' S <br /> LAUNOflY TRAV __ TOiAL PEE S � <br /> CLOfHES WASNER _ TNIS PEPMIT 9ECOMES Nl LL ANO VOID IF WORK OR CONSTRUG <br /> WATER HEATER iION AUiIiORIZED IS NO' COMMENCED WITMIN 120 DAVS,OP IF <br /> URINAL �- CONSTRUCTION OF WORI. IS SUSPENIJED Ofi Al1ANDONED FOR A <br /> ORINKING FOUNTAIN PkFIOD OF 110 �AVS AT ANV TIME AFiER WORK IS COMMENCEO. <br /> FLOOR-SINK OR DRAIN I 11[REIIV CERTIFV THAf I HAVE REAU AND E%AMINEO tH15 AP- <br /> VACUUM OREAKERS _ ___t_ PLICATION AND KNOW 1HE SAME TO �E TRUE nNft CUfiIiCCT. AlL <br /> PROVISIONS OF LAWS P!!C OfiDiNANCES (tObERNING THIS TVPE <br /> _ RODF DRAINS-RAINLEA�ERS .F WOAK WILL BE COIIPUEU WITII WHGTMER SPECIFIED MEREIN <br /> SINK ISERVICE-BAR, ETC.I _ �- OH NOT, THE GRANTIVG OF A PERMIT UOES NOT PRESUME TO <br /> �i GIVE AUTHORITV TO VIOLAiE OR CANCEL THE PROVISIONS OF <br /> ANV OTNEP STA1 h O'1 LOCFL LAW fiEGULATING CONSTRUCTION <br /> OR THE PERI'ORMANLE OF CONSTAUCTION. <br /> SUBiOTAL <br /> PERMIT f <br /> TOTAL FEE 5 <br /> __ '—_ - X l"-__ <br /> w�iir' <br /> � SIGNATUREOFCO'JTRACTOPORAUiH.AGENT DATE <br /> I SIOE V�D SEI9ACK STREfT.SMETBACK REAR yVA�qDSET�ACK PLAN CMECK NUM9ER PLAN CHECK FCE <br /> ar �q/ � FEE �� qECEIPTNO. <br /> USE 20NE LOT AR_yEA� VACANT SITE <br /> �� �I�" �'E5 ❑NO fEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF DWELLINti <br /> � • UNITS � I <br /> i <br /> 1 <br /> 512E OF ULUG, NO.OF STORIES MA%.00C. iOAO DUILDING E � � <br /> FIAE ZONE BASEMENT FIRE- 5 RI�NKLEiiS PLUMOING M <br /> ��.y d� <br /> � � �l�Mr n ❑VESEO �VO MECHAf11CAL <br /> 8 �oG <br /> SPECIAL CONnIT10N5' OTHEF � <br /> _--_ —_ _ I <br /> PENELT'/ SEC. 70JIa1 I <br /> -����,n� -- --- io6 �ao <br /> . iOTAL <br /> PERhI�f VALIDATION <br /> -- --- '- - -- Y.�IICNPHOPE�!_'i VALIUAtE�IIN1r115vPACEli//131SY0URPEliMIT <br /> ♦PVIIfRII11N>CCLP'fI)BY I'L�NSCMi/'Y[LtlY .`IPPUVIDfO Ii5lIR11fiflY <br /> Q <br />