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the Evergreen CONSTRUCTION everett <br />CITY OF it PERMIT <br />everett <br />CITY HALL 250-B745 <br />EVERETT, WA 96201 COMBINATION - BUILDING - MECHANICAL - PLUMBING .e <br />OWNER <br />MAIL ADDRESS - <br />ZIP <br />PHONE <br />TIM SCH[=IMER <br />659-4069 <br />m <br />_ _ <br />_ <br />ARCHITECT OR DESIGNER <br />MAIL ADDR ESS <br />PHONE <br />LICENSENO. <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />PHONE <br />LICENSE NO. � <br />z <br />SAME <br />c <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />PHONE <br />LICENSE NO. 1 <br />W <br />T <br />rtnmll CLASS OF WORK <br />Cl COMBINATION <br />BUILDING ❑ PLUMBING ❑ MECHANICAL <br />❑NEW ❑ADDITION Cl ALTERATION ❑REPAIR <br />VALUATION OF WORK ry� <br />S 00.00 tW DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL - <br />DESCRIBE WORK <br />EI40LISH SINGLE P'A;•ffI,Y UoTELLING <br />PROPOSED USE <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH TYPE OF ENERGY <br />FOUR COPIES) ❑GAS ❑ELEC. <br />LOT �GG_ BLOCK OF BEVMY HTLIS IT IN TYPE OF EQUIPMENT FEE <br />AIR COND. UNITS—H.P. EA. S I <br />REFRIGERATION UNITS—H. P, EA. <br />BOILERS—H.P. EA. I <br />FORCED AIR SYSTEMS—B.T.U. MI <br />JOB ADDRESS SPACE & WALL HEATERS — B.T.U. <br />6612 rmm =G UNIT HEATERS—B.T.U. <br />PLUMBING EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />NO. TYPE OF FIXTURE OR ITEM FEE AIR HANDLING UNIT— C.F. <br />DRINKING FOUNTAINS <br />I <br />FAC. BUILT FIREPLACE &CHIMNEY <br />GAS. SYSTEM: NO OF OUTLETS <br />SUBTOTAL S <br />PERMIT $ <br />I <br />I <br />FLOOR DRAINS <br />I <br />KITCHEN SINKS & DISP. <br />1 <br />BAR SINKS <br />I <br />ROOF DRAINS — RAIN LEADERS <br />I <br />TOTAL FEE $ <br />I <br />SHOWER BATHS <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 OHDINANCES 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 j <br />OR THE PERFORMANCE OF CONSTRUCTION. rw <br />SERVICE SINKS <br />SUMPS — SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />I <br />WATER HEATERS —ELECTRIC <br />I <br />WASH BASINS <br />1 <br />LAUNDRY TRAYS <br />1 <br />1 <br />TOTAL FEE X%/1, <br />TER SERVICE SIZE BLDG. SUPPLY SIZE SIGNATURE OF CONTRACTOR OR AUTH.AGENT DATE <br />1E YARD SETBACK STREET SETBACK REAR YARDSETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />E ZONE LOT AREA VACANT SITE <br />OYES ONO FEES VALUATION I FEE <br />SIZE OF BLDG. NO. OF STORIES MAX. OCC. LOAD BUILDING $ 00. 00 OOIOO .I <br />PLUMBING i <br />FIRE ZONE BASEMENT F-IRESPRINKLERS <br />REQUIRED I <br />OYES ONO MECHANICAL I v <br />I <br />SPECIAL CONDITIONS: OTHER I <br />[ PENALTY SEC. 303(a) I <br />TOTAL GG jO <br />PERMIT VALIDATION - ++ <br />WHEN PROPERLY VALIDATED( 511(f4SPACFy,ffft AQ'�1 R`�HMIj <br />� .. ��jj ��j <br />W <br />Y'O`L�UARRECEIPT,°.,,.,° <br />APPLICATION ACCEPTED bY: PLANSCHECKEDBY'. T <br />PROVED FOR ISSUANCE IIY: 71 HANK YOU <br />1. c. <br />ADDRESS FILE 7 0 JM 7g <br />