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I thr Evr�gnw�r I <br /> ���� �>� CONSTRUCTION everett <br /> I everett PERMIT <br /> �,..,�„ „,,,a <br /> IVIRII� 1t>SN'YiIh�N <br /> �e)'n <br /> "`°` °;,;,;;°�,;;, BUILDING MECHANICAL PLUMBING <br /> OWNER MAII AUDfi[55 Ziv PIIJN[ <br /> .•aars �e�s !&fR r.t� s+r.a <br /> Ai1CH1TECT OR OFSIGNEH M111L AOORE55 PMpryE LICENSF N�) <br /> GENERALCONTRACTON p�MAIL�ADDRESyS �� PNONE IJCFNSENO. <br /> � � � 7� n�rtwaufe! � � � <br /> MECMANICAL CONiFACTOR MNL ADOP.C55 PHONE LICENSE NO. <br /> PLUMpING CONTRACTOR MAIL ADDRE55 PHONE �,ICENSt NO. � <br /> W <br /> m <br /> PEPMIT � CLASSOF WORK � <br /> 7 <br /> �UILOING �PLUMpING �MECIIANICAL Z <br /> ❑N[W ❑�ODITION ❑ALTEHATION �fiEPAIR ~ <br /> VA�VATIONOFWORK — � <br /> s�� ❑OEMO11511 ❑FENCF ❑SIGN ❑SWIMMINO POOL W <br /> a <br /> OESCRIA�WORK � �I -'--- �--�-'----'-- '— - I <br /> oOV <br /> PFOPOSED USE <br /> MECHANICAL <br /> rvPi o��uc��oi� ❑Nnr. p���r,—❑ei cc. � <br /> LCG�L OESCRiP�ION OF PROPERTY ISHOW pELOW OR A1Tl�CII ppg I <br /> FpUR PIES • <br /> �-�T �� �cKior__�� A�� _ N4�. _ �TVPEOFE�UIPMENT___ FEE � <br /> nIRCONO. UNITS-M.P. El�. s � <br /> fiEFRIGERATIDN UMIiS -H,P. EA. <br /> F10LLER5 H.P. EA � <br /> Gq5 FIRED A!C. UNI15 �iONNAGE EA. <br /> FORCEO AIR SYSTEMS� B.1�.U. M EA. � I <br /> JOB ApOPESS �!� WALL HEATERS P.T.U. M <br /> � ^"��"�� UNIT MEMEPS-O.T.U. M I I <br /> PLUMBING EVAPpRAiIVECOOLERF � <br /> CLOTNESORYEFS � <br /> � VENiILATIONFAN �— <br /> RANGENO00 � <br /> NO. TVPE OF FIXTURE OR ITEM FEE ��R Ml1N�LING UNIi- C.F.M. <br /> WnTEFC1A5ET�TOILETI f �NCINERATOR � <br /> __ .. _-'__.__ ' - _ <br /> F1nTHTUf1.. <br /> _-_� LAVMOfiYIWASNBASIN) — --- � <br /> SHOWEIi — — - _--- .- <br /> KITCNEN SINK 6 DISP. — ----- --�--�- <br /> OISHWASHER __ _" SUPTOTAI $ � <br /> LAUNpqVTRAV -- <br /> PEPMIT f <br /> _ CLOTMES WASHER TOTAL Ff F. S � <br /> WMER HEATER �- THIS PEFMIT BECOMES �JLL ANO VOID IF WORK OR CONSTRUC� <br /> --� ------ TION AUTHOqIZEO IS NOT COMMFNCEO WITMIN I]0 OAVS, OR IP <br /> URINAL CONSTPUf.T1pN OR WORK IS SUSPEN�)ED OR I10ANOONEO FOR A <br /> �RINKING PoVNTAIN PERI00 OF 190 DAYS M ANv TIME qPTEN WORK IS COMMENCED. <br /> FLOOR- SINK OR URAIN 1 HEREfv CERTIFV iNnT I 11�VF fiEAD nNp Ek�MINED THIS AP <br /> VACUUM �REAKEPS �LICnTION ANO KNUW iME SAMf. ln IIF TF JE ANO COf�HF.CT. ALL <br /> HOOF DRAINS�RAINLEADERp --� ��t�V151ON5 Of LAWS ANO OHbIN�1NCE5 GOVERNINO T/IIS TVPE <br /> � � OF WORK N�I�� BE COMPLIED JJITfI WNETMER SPECIFIf:O NCREIN <br /> S�NK ISERVICE-BAR, ETC.) OR NOt. TME GR�NTINC OF A PERfAII pOES NOT PRESUME TO <br />' GIV[ AUTHORITY TU VIOV.iE OR C9NCEL TME PROVISIONS OF <br /> /1kV OTHEfi STATE OR LOG4L LAW f1EGUlATINtiCONSTRUCTION <br /> _ SUB TOTAL - i OH THE PEqFORM4NCE OI CONSTFUCTION. <br /> __.___ PERMIT ._.__ s _"-'_-"�'._ //I , <br /> _TUTAL FEE E —� ' <br /> - __ _ ___'__ _-__l--_. �. � <br /> SIGN�/ T�UREOF OVT�OR/ORnUi .AGENi DATE , <br /> SIDE Vf1'iDSETBACh SiNFEi SETpACK REAR VANDSETBACK PLAN CHF.CK NU�dflER PIANCMECK fEE <br /> PEE qECEIPT NO. <br /> USE IO�E LOT AflEA VACANT SITE <br /> ❑vEs ❑No �EES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF OWELLING <br /> UNITS <br /> I <br /> SI2F Of A1_�G. NO. OF STORIES MA%.OCC.LOnD I1UIl OING y � �M <br /> _ -_�_ / <br /> PI.UMBING � <br /> fIREZONI� � 6ASEMFNI FIqESPRINKL PS <br /> RfOUIqE[) -' <br /> ❑vE5 ❑NO MECMANICAL � <br /> —i-_. <br /> SPECIA,.CONDITIONS_ OTNER � <br /> - 1 <br /> -'--- ------- - P[NELlY SF.C. ]O�Id I <br /> —__._"_-_. ___— _ '.______-__- _'-__-_1_— <br /> TOTAL � /� <br /> w <br /> PERMIT VALIOATION <br /> - WHfN PRUPLfiI V VA1 iD4TFl� IIN TIIISSPACFI T111515 VOUR P[RMIT <br /> •1'I'I�C�iIf1NAfC[P�fOflV >IANSIIPICFYOflY �PoROVIII(P�K91nWINv <br /> w e. �.» �;. <br /> � <br />