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the Evergreen <br />CITY 01- CONSTRUCTION <br />everett PERMIT <br />CITY HALL 959 US$ <br />EVERETT. WASHINGTON <br />98101 <br />DEPT. OF CTY <br />0[VELaPNILOPNCNT BUILDING MECHANICAL PLUMBING <br />everett <br />OWNER y��.� ��1L.� �MMAIILL.�AA�DDRESS �ZIPP PHONE <br />ift aft i &ml nya Tf-2m a uA <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />S <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.� <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />� <br />W <br />m <br />PERMIT <br />±�, BUILDING <br />,� El El <br />—X <br />CLASS OF WORK <br />NEW ❑ADDITION El ALTERATION ❑REPAIR <br />Z <br />VALUATION OF WORK <br />$ <br />❑DEMOLISH ❑FENCE El SIGN ❑SWIMMING POOL <br />cc <br />W <br />CL <br />DESCRIBE WORK <br />%Bun owe scows" &Ivww <br />1254 <br />PROPOSED USE <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK <br />TYPE OF FUEL ❑OIL ❑NAT. [_]LPG.❑ELEC. <br />GAS <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />—OF <br />AIR CONO. UNITS-H.P. EA. <br />5 I <br />REFRIGFRATION 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 />iUNIT <br />WALL HEATERS-B.T.U. M <br />HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) <br />$ <br />INCINERATOR <br />BATHTUB <br />LAVATORY(WASHBASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUB TOTAL 5 <br />I <br />DISHWASHER <br />PERMIT 5 <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />TOTAL FEE 5 <br />1 <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 />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 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 <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />$ <br />SIGNATU RE OF CONT flACTOR OR AUTH.AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />❑YES [:]NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />BUILDING <br />5 <br />9 po <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />I <br />FIRE ZONE <br />BASEMENT <br />FIRE SPfl INK LERS <br />REQUIRED <br />❑YES ❑NO <br />MECHANICAL <br />SPECIAL CONDITIONS: <br />OTHER <br />I , <br />PENELTY <br />SEC. 303 (a) <br />i <br />TOTAL <br />9 b <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />3 <br />APPLICATION A�C9CEPTEDBY: <br />hN� <br />PLANS CHECKED BY: APPROVED <br />FF LAIISSUANCE BY. <br />• <br />