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the Evergreen <br />CITY OF <br />eve rett <br />CITY HALL 2598885 <br />EVERETT, 1YASHINGTON <br />98201 <br />DEPT, OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNER MAIL ADDRESS ZIP PHONE <br />�,YI? yC i' 28 E7 <br />3965-% <br />ARCHITECT OR DESIGNER MAILADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUM BING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />UJ <br />m <br />PERMIT <br />MUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW Cl ADDITION ❑ALTERATION []REPAIR <br />z <br />~ <br />VALUATION OF WORK_ <br />.',JA( <br />s <br />❑DEMOLISH ❑FENCEIGN ❑SWIMMING POOL <br />LU <br />W <br />a <br />DESCRIBE WORK LAT� <br />190 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑GAAT. LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT __ BLOCK —OF <br />NO. I <br />TYPE OF EQUIPMENT <br />FEE <br />I AIR COND. UNITS—H.P. EA. <br />S I <br />REFRIGERATION UNITS—H.P. EA. <br />BOILERS—H.P. EA. <br />I <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />FORCED AIR SYSTEMS—B.T.U. M EA. <br />I <br />JOB ADDRESS± <br />m ray <br />WALL HEATERS—B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />V CNTILATION FAN <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 />5 <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK &DISP. <br />SUBTOTAL 4 <br />I <br />DISHW ASHEfl <br />PERMIT S <br />LAUNDRY TRAY <br />TOTAL FEE S <br />I <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTR'JC- <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 HERE'N <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 />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR —SIN'. OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE —BAR. ETC.) <br />SUBTOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />4 <br />SIGNATURE OF CO NTRACTOR OR AUTH. AGPNT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARDSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />WO OF UNITS DWELLING <br />I <br />BUILDING <br />S Q� <br />512E OF SLOG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FI REZONE <br />BASEMENT <br />FIRESPRINKLERS <br />REQUIRED <br />❑YES ONO <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />PENELTY <br />SEC. 3031B) <br />1I <br />TOTAL <br />.W OD <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />3 <br />APPLICATION ACCEPTED BY: <br />PLANS CHECKED BY: <br />APPROVED FOII ISSUANCE BY. <br />2a c* <br />