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everett PERMIT <br />CITY HALL 7598885 <br />EVERETT, WASHINGTON <br />98281 <br />DEPT. O E COMMUNITY DEVELOPMENT BUILDING MECHANICAL PLUMBING �.eOWNER <br />MAIL ADDRESS ZIP PHONE <br />VIE!L. & ASGIX,,* nT fi1 FS:i W: j <br />ARCHITECT OR DESIGNER MAIL AODRFSS PHONE LICENSE NO, <br />GENERAL gCONTRACTORACCTTORR `w + MAIL ADDRESS PHONE LICENSE NO. <br />Wmi t *MU �l Yhbfi- <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cc <br />PLUMBING CONTRACTOR MAILADDRESS PHONE LICENSE NO. <br />W <br />m <br />PERMIT <br />ITSUILDING ❑PLUMBING []MECHANICAL <br />CLASS OF WORK <br />NEW ❑AUDITION ❑ALTERATION REPAIR <br />(Z❑ <br />D <br />z <br />F- <br />VALUATION OF WORK <br />S "*MOO <br />[]DEMOLISH❑FENCE ❑SIGN []SWIMMING POOL <br />cc <br />Lu <br />C <br />DESCRIBE WORK! y. i�� mT am !� <br />{i(S.1'?a::�ii E3si'+'L �Tll� +'iL.�llr <br />1 ^ p A <br />Vy 'GJ GJi <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL [:]OIL-❑GAAS. ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <br />918M,�y <br />8ell5S�AtFlLB�E� <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />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 />•"�'�'R �} <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 />1 <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />S <br />INCINERATOR <br />I <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUBTOTAL S <br />1 <br />DISHWASHER <br />PERMIT 5 <br />LAUNDRY TRAY <br />TOTAL FEE $ <br />I <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />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 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 />x � i�+ 2 qn <br />URINAL <br />DRINKING FOUNTAIN <br />IPERIOD <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />$ <br />SIGNATURE OFCONTRACTORORAUTH.AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />79%ixt <br />PLAN CHECK FEE <br />FEE RECEIPT jd0. <br />wi <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />❑YES ❑NO <br />FEES <br />4LUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />I <br />BUILDING <br />S J81�}SAI�/�V✓ <br />{L <br />5 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. GCC. LOAD <br />PLUMBING <br />FIR -ZONE <br />BASEMENT <br />qE It SPHI KLERS <br />OYES Cl NO <br />MECHANICAL <br />OTHER <br />1 <br />SPECIAL CONDITIONS: <br />I <br />PENELTY <br />SEC. 303 (B) <br />I <br />TOTAL`yjgxj <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PEFMIT <br />APPLICATIONACCEPTEDBY: PLANS CHECKEOBY: APPR(11( EO ESOP ISSUANCE BY: <br />mow! Q <br />