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tl�r Ever�reen I <br /> CITY Of- CONSTR UCTION everett <br /> everett PERMIT <br /> LiIY HALI ]5990A5 <br /> EVEPEIi,WASIIINGI04 <br /> se:ai <br /> °E" °°°°''^,°'°'� BUILDING MECHANICAL PLUMBING <br /> OEVELO>MCNT <br /> OWNEF MAILAODRESS ZIP PHONE <br /> 1''..X�T�Fi� dG?�'.3 tt di".tt?5 ��ft <br /> ARCHITECT OR OESIGNEfl MAIL ADD(iESS PHONE LIGENSE NO. <br /> GENERALCONTRACTOFi MAILADURES� PHONE LICENSENO. <br /> �� � <br /> MECHANICALCONTRACTOR MAILADDRESS PHONE LICFNSENO. <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. � <br /> W <br /> �.7���2i: �,� r`t..�.�.� m <br /> PERMIT ('�.A55 OF WORK � <br /> Z <br /> ❑ BUIIDING � PWMBING �MECHANICAL �NEW ❑l�DOITION ❑ALTERFTION ❑REPAIR ~ <br /> � <br /> VALUATION OF WORK � <br /> 5 ❑DEMCLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br /> DESCRBF WpRK S�O <br /> PROPCSED USE MECHANICAL <br /> I.EGAL DESCRIPTION OF PROPERTV (SHOW BELOW OR ATTACH T�PE Of- FUEL �OIL ❑Gn5 ❑LPG. �ELEC. <br /> FOVF COPIE5) <br /> LOT BLOCK_oF NO. _ TYPEOFE�UIPMENT FEE <br /> AIR CON�. UNITS-H.P. EA. 5 I <br /> REFRIGERATION UNITS-H.P. EA. <br /> BOILERS-H.P. EA. I <br /> GAS FIRED A.C. UNITS-TONNAGE EA. <br /> FORCED Alfl SVSTEMS-B.T.U. M EA. I <br /> J08 ADORESS ��Q �y� WALL HEATERS-B.T.U. M <br /> "�'�� �'w �� �'� UNIT HEATEftS-B.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTHES DRVERS I <br /> VENTII.ATION FAN <br /> RANGEHOOD I <br /> TYPE OF FIXTURE OR ITEM FEE A�R HANDLING UNIT- C.F.M. <br /> WATER CLOSETITOILET) 5 INCINERATOR I <br /> BATHTU� <br /> LAVATORYIWASHBASIN) I <br /> SHOWER <br /> KITCHEN SINK& DISP. SU8 TOTAL 5 � <br /> DISHW4SHER PERMIT 5 <br /> LAUNDRY TRAY T�TAL FEE 5 <br /> 1 <br /> CLOTHES WASHER THIS PERMIT 6ECOMES NULL AND VOID IF WORK OR CONSTRVC- <br /> WATER HEATER TION AUTHORI2[D IS ^:OT CO^.1�dEP:CGD LV�4-;Jil:: '.2!] 0.4VS, OR IF <br /> URINAL CONSTRUCTION OR WORK IS SUSPENDEO OR At3ANDONED FOii A <br /> � DPINKING FOUNTAIN PERIOD OF tt0 �AVS AT ANY TIME AFTEF WORK IS COMMENCEO. <br /> FLOOR-SINK OR ORAIN I HERE6V CERTIFV THAT I HAVE READ AND E%AMINED THIS AP� <br /> VACUVM BREAKERS PLICATION ANO KNOW THE SAME TO 6E TFiUEl�ND CORRECT. ALL <br /> PROVISIONS OF LAWS f.ND ORDINl1NCE5 GOVERNING THIS T""E <br /> ROOF DRAIN. -RAINLEADERS OF WORK WILL BE COAAPLIED WITH WHETHER SPECIFIED HEficIN <br /> SINK (SEFiVICE-9PF. ETC.) �— OR NOT, -F;F GRANTING OF A PERMIT DJES NOT PRESUME TO <br /> GIVE AUTFIORITV TO VIOLATE OR CANCEL THE PfiOVI5�ON5 OP <br /> ANY OTHSR 2'I FTE OR LOCAL LA�V R[GULATING CONSTRUCTION <br /> OR THE PicRFOfiMANCE O� CONSTHUCTION. <br /> SUB TOTAL <br /> PERMIT 5 <br /> TOTALFEE S <br /> x <br /> 31GNATUREOFCONTRACTORORAUTH.AGENT DATE <br /> SIDE VARD SET�ACK STREET SETBACK qEAfl V.�RDSETBACK PLAN CHECK IJUMBEft PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANTSITE . <br /> ❑vES ❑No FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING � <br /> UNITS � <br /> L— <br /> SIZE OF 81.UG. NO. OF STORIES MAX.OI'C. IOAO BUILOING S � <br /> I <br /> PLUM�ING {;� W <br /> HRE20NE UASEMENT HRESPRINKLERS � _ <br /> HfaUIftGD I <br /> ❑VES ❑NO MECHANICAL I <br /> SPECIAL CONDITIONS: OTHER � <br /> I <br /> — PENELTY SEC.J031a) I <br /> TOTAL �� � <br /> PERMIT VALIDATION <br /> WHEN PROPEIiLY VALIDATEO (W THIS SPACE) THIS IS�'OUR PEBINIT <br /> APPLILATIOflALCEFTEDOY'. PL�NSCH[CKCOOY' ACPIIOVEDFONISSU�NC[BY. <br /> �� 4� <br /> � <br /> —C]_ ' <br />