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the Evergreen <br />CITY OF <br />everett <br />CITYNALL MIM <br />EVERETT. Pf"KINGTON <br />11"I <br />DEPT. Of COMMUNITY BUILDING <br />DEVD aPMf NT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING <br />OWNER MAIL ADDRESS lII' PHONE <br />•Ii VA ••�.�P�"J <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />^?! ^^ <br />•I( <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />*.iies Aor7YA roof <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cc <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO <br />W <br />m <br />PERMIT <br />613UILDING ❑ PLUMBING ❑ MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ff6EPAIH <br />Z <br />H <br />i <br />VALUATION OF WORK <br />f <br />❑DEMOLISH ❑FNCE ❑SIN SWIMMING POOL <br />6 <br />a <br />DESCRIBE WORK <br />%w off rwr ad � 10A � !ODl. <br />w w O <br />L b <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑011 NAT. LPG. ELEC. <br />GAS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR PIES) af.,� <br />Lot � BLOCK _ OF FEirrm% ham <br />j., <br />/✓+1 — <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />f I <br />REFRIGERATION UNITS--H.P. EA. <br />BOILERS-H.P. EA. <br />1 <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-S.T.U. M EA. <br />I <br />JOB �ADDRESS <br />f'yu <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />I <br />__ <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I __ <br />WATER CLOSET (TOILET) <br />f <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />SHOWER <br />KITCHEN SINK A DISP. <br />SUBTOTAL f <br />I <br />DISHWASHER <br />PERMIT i <br />LAUNDRY TRAY <br />TOTAL FEE f <br />I <br />__ <br />CLOTHES WASHE' <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 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 />X <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />f <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEAOERS <br />_ <br />SINK (SERVICE -BAR, ETC.1 <br />SUB TOTAL <br />_ <br />PERMIT <br />f <br />TOTAL FEE <br />f <br />SIGNATUREOF CONTRACTORORAUTH.AGENT DATE <br />SIDEYARDSETBACK <br />STREETSETBACK <br />REARYAROSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE (RECEIPT NO. <br />VALUATION FEE <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES _ <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO.OS DWELLINGUNIT <br />1 <br />BUILDING <br />f2>,Wl7oW <br />3S'P <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE 20NE <br />AS NT <br />1 a RINKL S <br />RCOUIRED <br />OYES ONO <br />MECHANICAL <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />PENELTY <br />SEC. 003 (a) <br />1 <br />TOTAL <br />I <br />IERMIT VALIDATION <br />VHEN PROPERLY VALIDATED ON THIS SPACE) THIS 15 YOUR PERMIT <br />