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the Ebeiqreen <br />CITV OF <br />everett <br />Ci1V NAII 159fiA65 <br />EVEPFii.IYASNINLION <br />98t�1 <br />OEOi.0iC0A1F1UtiliY BUILDING <br />�FVIIOPMEMi <br />CONSTR�JCTION <br />PERI'�IT <br />MECHANICAL PLUMBING <br />everett <br />OWNER MAI�AD�RESS ZIP PHONE <br />�t, �..;�,i.n„ �,; ;-:o�,..,�y '�:jY <br />ARCHITECT OR �ESIGNER MAIL A�DflESS PHONE LICENSE ND. <br />1574-76 <br />GENERqLCONTRACTOR MAILAD�RESS PHONE LICENSENO. <br />MECHANIGALCONTRACTOR MAILADORE55 PHONE LICENSENO. <br />�r c r <br />PLVMBINGCONTRACTOR MAILADOHE55 PHONE I.ICENSENO. � <br />W <br />m <br />PERMIT Gl.ASS OF WORK � <br />z <br />❑ DUILDING ❑ PLUMBING � MECHANICAL � <br />❑NEW ❑ADOITION ❑ALTERATION �REPAIfl � <br />VALUATION OF WOPK � <br />5 ❑DEMOLISN ❑FENCE ❑SIGN ❑SWIMMING POOL a <br />DESCRIBE WORK 1503 <br />: `�.�i� �1�� <br />PROPOSED USE <br />MECHANICAL <br />LEGAL OESCRIPTION OF PROPERTV ISMOW BEIOW OR ATTAGH TYPE OF FUEL �OIL �GAns. �LPG. �EIEC. <br />FOUR COPIE5) <br />LOT ULOCK—OF NO. TVPE OF E�UIPMENT FEE <br />AIF COND. VNITS-H.P. EA. 5 I <br />REFRIGEPATION UNITS-H.P. EA. <br />(301LER5-M.P. EA. 1 <br />GAS FIN[D A.C. VNITS-TONNAGE EA. <br />FORC[D AIR SVSTEMS-6.T.U. M EA. I <br />JO� ADDRE55 t2'�4 WALL NEATEPS-O.T.V. M <br />�-� T(�1.•-. UNIT HEATERS-�.T.U. M I <br />BVAPORATIVECOOLERS <br />PLU�HING CLOTHESUFYERS I <br />V ENTILATION FAN <br />RANGEHOO� I <br />AIR HANDLING UNIT- 0.F.M. <br />NO. TVPEOFFIXTUREORITEM FEE INCINERATOR I <br />WATEfiCLOSETITOILFTI 5 <br />DATHTU� <br />I.AVATORV (WASH BASIN) I <br />SHOWER � <br />KITCHENSINK&OISP. SUDTOTAL 5 <br />[JISHWASMER PERMIT 5 <br />LAUNDtiV TfiAV TOTAL FEE 5 <br />CLOTNGS WASNER THIS PERMIT BECOMES NULL AND VOID IF WOFK OR CONSTFUC- <br />WMER NEATER TION AUTHORI2ED IS NOT COMMENCEO WITHIN 120 DAVS, ON IF <br />UFINAL � CONSTRUCTION OR WORK IS SUSPENDEO OR A�ANDONED FOR A <br />ORINKING FOVNTAIN PERIOD OF /20 DAYS AT ANY TIME AFiER WORK ISCOMMENCE�. <br />FI.00R-SINK UR DRAIN � HEREFIY CERTIFV THAT I HAVE flEAD AND E%AMINLD THIS AP� <br />VACWh1 (3qEAKERS � PLICATION AN� KNOW THE SAME TOOE TRUE AND CORN[CT. AlL <br />—}— PROVISIONS OF LAWS ANO ORDINANC[5 GOVERNING TIi15 TVPE <br />ROOF ORAINS-FAINLEADEfiS OP WORK WILL DE COMPLIE� WITH WHETHER SPECIFIED HERE�N <br />SINK (SERVICE-UAR, ETC.) OR NOT, THE GRANTING OF A PERMIT OOES NOT PNESUME �O <br />GIVE AUTHOPITV TO VIOLATE Oft CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION <br />OR THE PEFlFOPMANCE OF CONSTHUCTION. <br />SUUTOTAL <br />PERMIT $ <br />TOTAL FEE $ _ _ 4 " <br />X�'� 7 �� <br />SIGNATUREOFCONTRACTOROPAUTH.AGENT DATE <br />510@VARDSETOACK STREETSETOACK REARVARDSET�ACK PLANCNECK NUMOER PLANCHECKFEE <br />FEE REGEIPT NO. <br />USE ZONE LOT AREA V.4CANT SITE <br />[]vE5 ❑No FEES VALUATION FEE <br />TVPE OF CONST. OCCUPANCY GROUP NO.OF OWE' LING <br />UNITS � <br />SIZE OF BLOG. NO.OF STORIES MAX.00C. LOAD BUIL�ING 5 � <br />I <br />PLUM�ING � <br />FIREZONE BASEMENT FIIiESPqINKLEfiS <br />fiEQU1qE� <br />❑VES ❑NO MECHANICAL � <br />SPECIAL CONDITIONS: OTHER � <br />_ I <br />PENELTV SEC.3031a) � <br />TOTAL ? j � <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IIN THIS SPACEI THIS IS YOUR PEHMIT <br />AFPLICIiIONACCEPTE08Y: PLANSLIIfCKE08Y: APVPOVEDfO ISSURNC[OY: <br />� �! <br />� <br />