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i � <br /> thn. Evcrgreen <br /> ��T� o�- CONSTRUCTION everett <br /> everett PERn,":� <br /> urv�au is�eees <br /> NEflETI,IYAS�IIIIGION � <br /> eaaoi <br /> nerr.°ocv[iove�crr BUILDING MECHANICAL PLUMBING <br /> OWNEF MAILADOFESS ZIP I'HONE <br /> rq�Ut�'.� i�T1C1�.9lSiCYL'".3 `��}3 �`'{MYf3i7QY1 �`�2 C <br /> ARCHITECT OR OESIGNER MAIL ADORESS PHONE LICENSE NO. 7�C�,�o7 . � <br /> GENERALCONTRACTOR MAILADORE55 PHCNE LICENSENO. <br /> ��rt� t3�t �-c. �7 rat� ��. l�n¢arood T'��":��3, <br /> MECHANICAL CONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. <br /> � <br /> PLVM6INGCONTRACTOR MAILADDRESS PHONE LICENSENO. uJ <br /> m <br /> � <br /> PERMIT CLASS OF WORK � <br /> z <br /> �J DUILDING ❑ PLUM8ING �MECHANICAL ~ <br /> ❑NEW ❑ADDITION ❑ALTEflATION ❑REPAIR � <br /> VALUATION 9F WORK pv, � <br /> �'MnaM ❑DEMOLISH ❑FENCE L" SIGN ❑SWIMMINGPOOL W <br /> 1N ' W n' <br /> OESCRIB[WORK �/� �f e <br /> � 1 � <br /> PROPOSE� USE MECHANICAL <br /> �` � l'YPEOFFUEI �OIL �GA�y. �LPG. �ELEC. <br /> �EGAL OESCRIPTION OF PROPEFTY ISHOW BEIOW OR ATTACH <br /> FOUR COPIES) <br /> NO. TYPE OF EQUIPMENT FEE <br /> LOT OLOCK—OF AIR CONO. UNITS-H.P. EA. S � <br /> � REFfiIGEftl1TION UNITS-H.P. EA. � <br /> 601LEP5-H.P. EA. I <br /> GAS PIfiED A.C. VNITS-TONNAGE EA. <br /> �i� `�jj�J� FORCED AIR SVSTEMS-B.T.U. M EA. I <br /> J06 AODRESS WALL HEATEFS-B.T.U. M <br /> UNIT HEl�TERS-B.T.U. fvi � <br /> EVAPORATIVECOOLERS <br /> PLUMBING C�OTHES DR�LRS i <br /> VENTILATION FAN <br /> RANGEHOOD � <br /> NO. TYPE OF FIXTURE OR ITEM FEE �+�R HANOLING UNI7- C.F.M. <br /> WATER CLOSET(TOILET) S INCINEflATOR � <br /> OATHTUB <br /> LAVATOR�'(WASH BASIN) � <br /> SHOWER <br /> Kll"CHEN SINK& DISP. SUB TOTAL 5 � <br /> DISHWASHER PEflMIT 5 <br /> LAUNDRY TfiAV TOTAL FEE 5 I <br /> CLOTHES WlaSHER 71i15 PEHMIT F3ECOMES NULL AND VOID IF WOFK Ofl CONSTRUC� <br /> WATER HEATER TION AUTHOfi12ED IS NOT CrJMA-1ENCED WITHIN 120 OAVS, OR IF <br /> URINAL CONSTqUCT10N OFi WORK IS SUSPENOED OR ABANDONED FOR A <br /> PERIOD OF 120 DAYS AT :•�Y TIME F�FTEF WORK �S COMMENCED. <br /> DRINKING FOUNTAIN <br /> FLOOF-SINK OR DRAIN I HEREE3V CEflTIFV THAT I HAVE READ AND EXAMINED THIS AP- <br /> PIICATIOP! ANO KNOW THE SAME TO BE TFV E ANO CORREGT. ALL <br /> VACUUM �REAKERS PFOVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TVPE <br /> ROOF DRAINS-RAINLEADERS OF WORK WILL 8E COMPLIED WITH WHETHcR SPECIFIED HEftEIN <br /> SINK ISLRVICE-BAR,ETC.) Oft NOT, TNE GFANTING OF A PERMIT L10E5 NOT PRESUME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS ("F <br /> ANY OTHEfl STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR TH[PERFORMANCE OF CONSTRUCT!ON. <br /> SU� TOTAL <br /> PERMIT <br /> TOTAL FEE S <br /> X �7� <br /> SIGNATURE OF CONTIiACTOROFi AUTH.AGENT DATE <br /> SIDE YARD SETI3ACK STftEET SETBACK REAR YARD SET6ACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV G��OUP UNITS OWELLING � <br /> 512E Of OLDG. NO.OF STGRIES MAX.00G LOAO BUILOING SI�ytIV��? �Y�W <br /> PLUMBING � <br /> FIREPONE BASEMENT FIFESPRINKIERS _ � <br /> RCQUIRED � <br /> ❑VES ❑NO Mf:CHANICAL I <br /> SPECIAL CONDITIONS: OTHER I <br /> I <br /> . PENELTY SEC.3031a) � <br /> TOTAL .�ZJ I� <br /> PEFMIT VALIDATION , <br /> WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS IS VOUP PFRMIT <br /> � <br /> iAPPUC�TIONA[CEiTEOBY: PL�NSLHECK[DOY: PVPBOVEOFOHISSUANCEBY. <br /> I N � <br /> � <br />