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- i <br /> tLc Evcrgr��en <br /> ��T,. o� CONSTRUCTION evereit <br /> everett PERMIT <br /> crtreau �s�ieaas <br /> fvENETL WASNIN4i0N � <br /> 98101 <br /> �E�� �����,^�����Y BUILDING MECHANICAL PLUMBIN <br /> o[ve�ovucxt <br /> OV�NEi} ,�,.,, MAIIAUDRESS ZIP PHONE ��� <br /> � 'Y�'�:' �YF <br /> ARCHITECT OR DESIGNER <br /> MAILADDRESS PHONE LICENSENO. <br /> GENERALCONTp�RACTOR MAILADDRESS PHONE LICENSENO. <br /> MEC 1ANICAL CONTflACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> � <br /> MAIL ADDRESS PHONE LICENSE NO. UJ <br /> PLUM�ING CONTR.�CTOR m <br /> � <br /> PERMIT CLASSOFWORK = <br /> z <br /> ��UILDING � PLVMBING ❑MECHANICAL ~ <br /> ❑NEW ❑AODITION ❑ALTERATION ❑REPAIF � <br /> t� � <br /> VALUATION OF WOFK w <br /> {Ap �yti ❑UEMOLISH ❑FENCE QSIGN ❑SWIMMING POOL a <br /> 5 ,:R.tiM'Ni — ^-/ <br /> DESCRIBE WORK 59 b <br /> tr'.+t:i �:��. :i�3J� <br /> PPOPOSED USE MECHANICAL <br /> TYPEOFFUEL �OIL �CnT. �LPG. �ELEC. <br /> FOUR COPSES)�PTION OF PROPERTV ISHOW BELOW OF ATTACH <br /> NO. TYPE OF EQUIPMENT FEE <br /> LOT BLOCK—OF qIR COND. UNITS-H.P. EA. 5 � <br /> REFRIGERATION UNITS-H.P. EA. <br /> LOIlEftS-N.P. EA. � <br /> GAS FIRED A.C. UNITS-TONNAGE EA. <br /> FORCEO AIR SYSTEMS-B.T.U. M EA. � <br /> JOB ADDRESS 'ry �rrvr) (, WALL HEATERS-6.T.V. M <br /> U� T;T�i�.'.e'.;;�e S't.F UNIT HEATEFS-B.T.U. M I <br /> EVAPOHC.TIVECOOLERS <br /> PLUMBING CLOTHEf• DRYEflS � <br /> � VENTIL�TION FAN <br /> RANGEHOOD � <br /> AIR HANDLING UNIT- C.F.�A. <br /> NO. TVPE OF FIXTURE OR ITEM FEE iNCINERA7oR � <br /> WATER CLOSET (TOILETI 5 <br /> BATHTUB I <br /> lq4PTnqVIWASH8A51M <br /> SHOWER SUBTOTAL 5 I <br /> KITCHEN SINK & DISP. PERMIT 5 <br /> DISHWASHFR <br /> LAVN�RVTFAV TOTALFEE 5 _ I <br /> CLOTHES W�+SHER THIS PERMIT BECOMES NULL ANO VOID IF WORK OF CONSTRUC- <br /> WATER HEATER TION AUTHOFIZED IS NOT COMMENCE� WITHIN 720 DAYS, OR IF <br /> CONSTRUCTION OR WORK IS SUSPENDEO Ofl ABANDONED FOF A <br /> URINAL PERIOO OF 720 DAVS AT ANV TIME AFTER WOflK IS COMMENCED. <br /> OFINKING FOUNTAIN I HEREBY CERTIFV THAT I HAVE REA� ANC EXAh11NED THIS AP� <br /> FIOOR-SINK OR�RAIN PLICATION APID KNOW THE SAME TO BE TftVE AND CORFECT. ALL <br /> VAGUUM �REAKERS PROVISIONS OF LAWS AND OPOINANCES GOVERNING THIS TVPH <br /> ROOF DFAINS-IiAINLEADERS OR NOTrTHE GRANTINGLOFDA ERM T��OES NOT IPflESUME TO <br /> SINK ISERVICE-BAfa. ETC.) u'IVE AUTHORITV TO VIOLATE OF CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LI�W REGULATING CONSTflUCT10N <br /> OR THE PERFORMANCE OF CONSTRVCTION. <br /> ISUB TOTAL <br /> I PERMIT � <br /> ( TOTALFEE S . �11fwnJitt. <br /> x I f 1.3/ {�+ <br /> .^.IGNATUflEOFCONTRACTORORAUTH.AGENT DATE <br /> PLAN CHECK FEE <br /> SIOE YAPD SETDACK STREET SETBACK REARYARDSETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> USE20NE LOTAREA VACANTSITE <br /> ❑YES ❑NO FEES VALUATION FEf <br /> TVPE OF GONST. OCCUPANCY GROUP UNITS DWELLING I <br /> SIZE OF �LDG. NO.OP STORIES MAX.000. LOA� BUILDING 5 /++�rs'JV j 1� <br /> I <br /> � PLUMBING I <br /> FIRE20NE �ASEMENT FIRESPRINKLERS � <br /> R Qy SED ❑NO MECHANICAL � <br /> � <br /> SPECIAL CONDITIONS: OTHER I <br /> PENELTY SEC.70310) � <br /> I <br /> TOTAL j�C� <br /> I PERMIT VALIDA�f10N <br /> WHEN PROPERLY VA�IDATED(IN THIS SPACE)THIS IS YOUR PEflM1T <br /> I APPPOVE�FOh155UANL[BY�. <br /> pPPLICAiIU`1ACCEFTEDBV: PlPNSCNECREO�Y: <br /> So C,s <br /> i <br /> I " <br />