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the Evergreen <br />CITY OF <br />everett <br />CITY NALL 25,8185 <br />EVERETT. WASNINrfaN <br />58}BI <br />DEPT. OF COMMUNITY BUILDING <br />oEVELnrnrzNr <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />evereft <br />PLUMBING <br />�,�M��AIIL ADDRESS ZIP PHONE <br />n RCHITECT OF DEEiI G NER MAIL ADDRESS PHONE LICENSE NO. <br />-E- --qL CfO�N...T��R,,,.A�CTOR fEEE�yN//MAiIrL�.AODRESS PHONE LICENSE NO. <br />wyyr i1W S+yeft" <br />_..r,nrvlcq�GUNTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />LU <br />W <br />C3 <br />PERMIT <br />BUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑ NEW ❑ADDITION ❑ALTERATION REPAIR <br />Z <br />Vq LUAT1ON OF WORK <br />2 wt <br />- <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />W <br />D_ <br />D ESCRIB: Wp RK --- <br />�'� 1435, <br />PROPOSE& USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑NAT. ❑LPG, ❑ELEC. <br />LEGAL DESCRIPTION OF PROPLRTY (SHOW BELOW OR ATTACH GAS <br />FOUR,F PIES) r� ice., <br />LOT BLOCK? OFF* =lr N 7 NO. I TYPE OF EQUIPMENT FEE <br />AIR COND. UNITS-H.P. EA. $ 1 <br />REFRIGERATION UNIT$-H.P. EA. <br />BOILERS-H.P. EA. <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS -B.T.U. M EA. I <br />_ <br />JOB ADO RE55 <br />• man �., �J <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 />VENTILATION FAN <br />RANGE HOOD <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT-C.F.M. <br />WATER CLOSET (TOILET) <br />5 <br />INCINERATOR <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUBTOTAL $ <br />PERh11TRYTRAY <br />ES WASHERTOTALFEE <br />3 <br />R HEATER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK ORCONSTRUC- <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 AFTERWORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />SOOF 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 />,, g % <br />$15"ASHER <br />L <br />ING FOUNTAIN <br />-SINK OR DRAIN <br />M BREAKERS <br />DRAINS-RAINLEADERS <br />SERVICE -BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />3 <br />SIG UR F CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREETSETBACK <br />REARYARDSETBACY. <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE --ONE <br />LOT AREA <br />VACANTSITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />SIZE OF RLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />BUILDING <br />3 <br />5 Ctc <br />PLUMBING <br />_ <br />1 <br />FIRE. ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />REQUIRED <br />OYES ONO <br />MECHANICAL <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />I <br />PENELTY <br />SEC. 303(a) <br />I <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />Q <br />APPLICATION ACCEPTED BY: <br />PLANSCNECr.EDBY: APPOOVVEEO}FON <br />ISSUANCE BY. <br />IiI3 <br />