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- -:: . <br /> thr. Evernreen <br /> CITV OF CONSTRUCTIOM ever�tt <br /> everett PERMIT <br /> LIIY NA�� )5988B5 <br /> EVEPEii.WASIIINGiON <br /> 9AI01 <br /> °`°` °`°°'^^'°""� BUILDING MECHANICAL PLUMBING <br /> u[vcioP�iErvr <br /> OWNER MAIL ADDftE55 ZIP PHONE <br /> �{� �f� !C�'..T,�f �''��' <br /> ARCh11TECTOFDE5IGNER MAILADDRE55 PHONE LICENSENO. <br /> GENERAL CONTRACTOR MAIL AD�RESS PIInNE LICENSE NO. <br /> MEC�HANICALCONTRACTOR MAIL A�OBGSS PHUNE LICENSE NO. <br /> �,�f'�� E�, �_i?���,`,� <br /> PLUM�ING CONTRACfOR MAIL ADDRESS PNONE LIC@NSE NO. � <br /> W <br /> m <br /> FERMIT CLASS OF WORK � <br /> Z <br /> ❑BUILDING ❑ PIUMBING Q�MECHANICAL F <br /> �NEW ❑ADDITION ❑ALTERATI'J1J ❑REPAIR � <br /> VALUATION OF WORK � <br /> $ ❑�EMOLISH ❑FENCE ❑SIGN ❑SWIMM.NG POOL a <br /> DESCRIBE WORK <br /> fi �t," riT"t.A� i��2� <br /> PROPOSED USE <br /> MECNANICAL <br /> TVPEOFFUEL �O�!. rNA7. �LPG. VELF'C. <br /> LEGq�DESCRIPTION OF PROPERTY ISHOW BE�OW OR ATTACH r:P3 <br /> FOUft COPIESI <br /> LO7 BLocK—OF NO. TVPE OF EQUIPMENT FEF. <br /> AIR COND. Uf�1T5-H.P. EA. > � <br /> REPRIGER4TION UNITS-H.P. EA. --� <br /> 601LER£-H.P. EA. � <br /> GAS FIFED A.C. UNITS-TONNA3E EA. <br /> FOFCED AIR SVSTEMS-E3.T.V. M EA. I <br /> JOB qDDRESS � WAL� HEATERS-B.7.U. M <br /> �n�i:� !� <br /> • UNIT HE%'�ERS-B.T.U. M I <br /> EVAPORA i NE COOLERS <br /> PLUMBING CLOTNESDftVERS <br /> I <br /> VENTILATION FAN <br /> R4NGENOOD � <br /> NO. TVPE OF FIXT�JRF OR ITEIA FEE A�p HANDLING UNIT- C.F.M. <br /> WATER CLOSETITOILET) 5 — INCINERATOR � <br /> BA7HTUB —T <br /> LAVATORY(WASHOASINI � <br /> SHOWER <br /> KITCHEN SINK & DISP. SUB TOTAL 5 <br /> OISHWASHER --T-- - ' <br /> - I PERM�T 5 <br /> LAUNDRYTRAY TOTALFEE 5 � <br /> CLOTHES WASHER THIS PEFMIT BECOMES NULL AN� VOIO IF WOFK OF CONSTFUC- <br /> WATER HEATER TION AUTHORIZED IS NOT COMMENCEO WITHIN 120 DAVS, OR IF <br /> URINAL CONSTRUGI'ION OR WORK IS SUSPENDF.D OF ABANDONED FOR A <br /> DRINKING FOUNTAIN �ERIOD OF 1?0 DAVS AT PNY TIM11E AFTER WORK IS COMMENCED. <br /> FLOOR-SINK OR DRAIN —~— I HEFE6Y CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br /> VACUUM BREAKERS PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> flOOf DRAINS-qqINLEi1DEPS PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 'iYPE <br /> OF WORK WILL BE COMPLIEO WITIi WHETHER SPECIFIED HEREIN <br /> SINiC (SEFVICE-6AR, ETC.) OR NOT, THE GFANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIO�ATE OR CANCEL THE PROVISION.^+ OF <br /> �— --- ANV OTHER STATF. JR LOCAL Ll�W REGULATING CONSTRUCTION <br /> _ OR THE PERFORMANCE OF CONSTFVCTION. <br /> SUe TOTAL <br /> PEFMIT 5 <br /> TOTALFEE 5 <br /> X <br /> SIGNATUREOFCONTRACTORORAUTH.AGENT OATE <br /> SIDE YARD SETOACK STREET SET6ACK REAR YAqD SETBACK PLAN CHECK NUM6ER PLAN CHECK FEE <br /> FEE flECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> ❑VES []r�0 FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPI�fJCY GROUP NO.OF DWELLING <br /> UNITS � <br /> SIZE OF BLDG. NO.OF STORIES MAX.00C. L0/1� BVILDING 5 � <br /> I <br /> PLUMFiING I <br /> rIRE20NE BASEMENT FIFESPRINKLERS I <br /> RCOUIRED � � <br /> ❑VES ❑NO MECHAHICAL � <br /> SPECIAL CONDITIONS: _ pTHER � <br /> PENELTV SEC.9031a) I <br /> TOTAL 71� <br /> PERMIT VALIDATION <br /> WHEN PROPEfiI V Vl�LIDATED (IN TI115 SPACEI TIi15 IS YOUR PERMIT <br /> APPL:CATIONdCC[PTFOBY: PL��!$C11ECY.EU�Y�. AFVNOV[DFORISSU�NC[BY. <br /> � C� <br /> � <br /> ��'] <br />