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. � . _�� <br /> the Evergreen <br /> CITYOF CONSTRUCTION - everett <br /> everett PERM�T <br /> LiIY�IALL .59°F95 <br /> EVEPFii,NASNINGLON <br /> 9B>01 <br /> °F" °'�°Ma°�^' BUILDII�G MECHANICAL PLUMBING <br /> 0[YELOPMEHT <br /> OWNER MAILAnpFESS ZIP PHONE <br /> J%'^�": h'3'.��'Y3IE�R ?�1-7� <br /> ARCMITECTORDESIGNER MAILADDRE55 PHONE IICENSENO. <br /> GENERALCONTRACTON MAILAODRESS PHONE LICENSENO. � <br /> +1F'.:'`�'.1 iX'A�T.I=r4rt� <br /> MECHANICAL CONTRACTOR MAIL ADOHE55 PHONE LICENSE NO. <br /> PLUMBING CONTRACTOR MAIL AODRE55 PHONE LICENSE NO. � <br /> W � <br /> m � <br /> _ _ � <br /> PEFMIT CLASS OF WORK � ' <br /> � z <br /> �BUILOING ❑PLUMBING ❑MECHANICAL L I- ' <br /> ❑NEW []ADDITION �` ALTERATION ❑REPAIR � <br /> V'�LUATION OF I�ORMK � <br /> 5 �.�y ❑�EMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL w <br /> a <br /> DESCRIBE WORK 1j�..�.. -.:.x�apL �*, [�:_�:^��TGi!�T� 0::"•'7('f' 6 03 <br /> PROPOSE�USE MECHANICAL <br /> LEGAL OESCRIPTION OF PROPERTV ISNOW�ELOW OR ATTACH TYPE OF FUEL �O�L �GAns. �LPG. �ELEC. <br /> Fouq�R1E51 +».r �-��v �� NO. TYPE OF EQUIPMENT FEE <br /> Lo7� �v BLOCK�� OF qIR COND. UNITS-H.P.EA. I I <br /> REFRIGEfiATION UNITS-H.P. EA. f <br /> DORERS-H.P. FA. I � <br /> GAS FIRED A.C. UNITS-TONNAGE EA. I <br /> FOFCED AIR SYSTEMS-B.T.U. M EA. I <br /> J06 A�ORESS '�t�Q WALL HEATERS-B.T.U. N. <br /> ^�' � ��� UNIT MEATERS-B.T.U. M I <br /> EVAPOqATIVECOOLERS <br /> PLUMBIN3 CLOTHES�RVERS I <br /> VENTILATION FAN <br /> RANGEHOOO 1 <br /> NO. TYPC OF FIX7URE OR ITEM FEE A�R HANDLING UNIT— C.F.M. <br /> WATEFCIOSET�TOILETI S �NCINERATOF 1 <br /> OATHTUB <br /> LAVATORY IWASH BASIN) � <br /> SHOWLR <br /> KITCNEN SINK& OISP. SUB TOTAL S � <br /> DISMIYASIIER PERMIT S <br /> L?VNDfiY TflAV TOTAL FEE 5 � <br /> CLOTHCS WASHER THIS PEFMIT UECOMES NULL AND VOID IF WORK OF CONSTRUC- <br /> Wl1TEP HEATER TION AUTNORI2ED IS NOT COMMENLED WITMIN 120 DAVS, Ofl IF <br /> UHINAL CONSTRUCTION OR WOFK IS SUSPENDED OF ABAN�ONED FOIi A <br /> fJiaNY:ING f-OUNTAIN PERIOU OF 170 DAYS AT ANV TIME AFTEP WORK IS COM1IMENCEO. <br /> FLOOIi-SINK OR ORAIN � I NEREBV CERTIFV THAT I HAVE READ ANO E%AMINED THIS AP- <br /> VACUUM1113liEAKERS PLICA-i ICN AND Y.NOW THE$AMG TO�E TRUE/1tRD CORRECT. ALL <br /> - PROVISIONS OF LAWS AND ORDINANCES GOVERNING TIilS TVPE <br /> ROOP DRAINS-FAINIEADERS OF WORK WILI �E COMPLIEO WITN WHETHEfi SPECIFIED HEREIN <br /> SINK (SERI'ICG-[3Afl,ETC.) Ofi NO"f, THE GRANTING OF A PERMIT OOES NOT PNESU�IE TO <br /> - GIVE AUTHORItV TO VIOLATE OR CANC[L THE PRGVISIONS OF <br /> ANY OTHEil STATE OP LOCAL LAW R[GU�ATING CONSTNUCTION <br /> OfiTHEPEFFORMANCEOFCONSTpUC110N. <br /> SU6TOTAL <br /> P[RM17 5 <br /> TOTALfEE S t,M4,��{.r�. <br /> x �^' ,`� <br /> SIGNATUREOFCONTRACTOHORAUTH.AGENT DATE <br /> SIDE YAflD SETUACK $TNELT SLTUACK REAR VAROSETOACY. PLAN CHECK NUMBER PLAN CHECK FEE <br /> USE 20NE LOT A(iEA VACANTSITE ���7 FEE �`� Fj�,G��� fJV. <br /> t 1.4 <br /> ❑vES ❑No FEES VALUATION FEE <br /> TVVE OF CONST. OCCUPANCY GROUP NO.OF DWELUNG <br /> UNITS I <br /> SIZE OF BLDG. NO.OF STORIES MA%.00C. LOAO BVILDING S �� � '�' <br /> PIUMeING � <br /> FIfiEZONE OASEMENT FIPESPRINKLERS � <br /> RF.DUIRED <br /> ❑vE5 ❑NO MECHANICAL I <br /> SPECIAL CONOITIONS: OTHER � <br /> � <br /> PENE�TY SEC.3031a) � <br /> TOTAL � � <br /> PERMIT VALIOATION <br /> WHEN PftOPERLV VALIOATEO(IN TNIS SPACE)THIS IS VOUR P[1i1.11T <br /> i <br /> AffLiUT10NACCEPTED9Y: PUNSLl1ELKEOBY: M>N��EOPOP�SSUANLtbY. <br />� R. c, K, r,. Y. C. <br /> 0 <br />