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� thr. Evr.rgrcen <br /> � °'T� °'` CONSTRUCTION everett <br /> ' ever�tt <br /> �,�.,,,,<< �,,,a,9s PERMIT <br /> EVEPEIL 1';45NINf10H <br /> 99IDI <br /> �FPi.�OEVEIOFMENf BUILDING MECHANICAL PLUMBING <br /> OWNER h1AIL AODRESS <br /> Z�N PHONE <br /> ?�illarl :'. :n.��:.� �:�:. _� , -.. '.�icN :�{ .�,,. :�rfv:. 9::�r� 3 .. <br /> ARCHITECT OR DESIGNER � 1 �� "�" ��'7z <br /> P.IAILAO�qESS PHONE LICENSENO. <br /> .�«��f <br /> ,'�I 7 <br /> GENERAL CONTRACTOR MAIL ADDRESS <br /> PHONE LICENSE NO. <br /> i'.r.n 'itin>»1 � ;•r.��:o '.� -.':'>- I:-._f-..;; _ <br /> MECHANICALCONTqqCTOR MAILAODRESS <br /> � PHONE LICENSE NO. <br /> PLUM6INGCONTRACTOR MAILADDRE55 (� <br /> PHONE LICENSE ND. W <br /> PERMIT m <br /> CLASS OF WORK � <br /> � <br /> Q.DUILDINC QPLUM�ING Q.MECHANICAL z <br /> O'NEW ❑qO�ITION ❑qLTERATION ❑REPAIR ~ <br /> VALUATION OF WORK � <br /> 5 �'S - ��IJ.�1 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMINGPOOL W <br /> �ESCRIBE WOFiK p, <br /> .,,: ;, :��u,,z� z•�,�.1��� ���:,�,�;,�:�:, 2199 <br /> PROPOSED USE <br /> 'T '�:.1�.'v.tcq MECHANICAL <br /> IEGAL OESCRIPTION OF PROPERTV ISHOW BELOW OR ATTACH T�NE OF FUEL �OIL �GAS. �LPG. ..ELEC. <br /> FOUR COPIE51 <br /> LOT �K_oF ��""�"'�-�� NO. TYPE OF E�UIPMENT <br /> FEE <br /> AIR COND. UNITS-H.P. EA. 5 I <br /> �-- �" ,� � REFRIGERATION UNITS-N.P. EA. <br /> �OILERS-Ii.P. EA. ' <br /> GAS FIFED A.C. VNITS-TONNAGE EA. <br /> JOB ADDRESS FORCEO AIR SVSTEMS-B.T.U. M EA. `J� . <br /> � ^ ' 7 • �.` WALL NEATERS-B.T.U. M <br /> ... . I���er ��v<-er.u�� <br /> UNIT IiEATERS-B.T.U. M I <br /> PLUMBING EVAPORATIV[COOLERS <br /> CLOTMESDRVERS s� � ,� <br /> VENTILATION FqN <br /> RANGE HOOD +s� ; <br /> N • TVPE OF FIXTURE OR ITEM FEE A�R HANDLING UNIT- C.F.M. <br /> WATER CLOSET ITOILET) 5 . INCINERATOR � <br /> � BATHTUB Y <br /> IAVATORY �WASH BASIN) „.� <br /> SHOWEP � <br /> �,� <br /> + KITCHEN SINK& DISP. <br /> DISHWASHER SUBTOTAL 5 __I �' <br /> LAUNDRYTqqY PEqM1T 5 <br /> CLOTHES WASMER TOTAL FEE $ �� �� - <br /> WATER HEATER , _ THIS PERMIT BECOMES NULI AN� VOID IF VJORK OR CONSTRUC-� <br /> URINAL TION AUTHORI2ED IS NOT COMMENCED WITHIN 120 �AVS, OR IF <br /> DRINKING FOUNTAIN FEOR OD OFT72O0 AV 5 �T ANYSTIME ADF7EF WORK SDCOM1EMENCE�. <br /> I FLOOR-SINY, OR DRAIN I HEREUV CERTIFV TIiAT I HAVE READ AND E%Ah11NE0 THIS AP� <br /> VACUUM BREAKERS PLICATION ANO KNOW TME SAME TO BE TRUE AND CORRECT, qLL <br /> ROOF ORAINS-RAWf.EAOERS PFUVISIONS OF LAWS AND ORDWl�NCES GOVERNING THIS TYPE <br /> SINK (SERVICE-�OAR, ETC.) �F \VORK WILL BE COMPLIED WITH N'HETNEq SPECIFIE� HEREIN <br /> OR NOT, TFIE GAANTING OF A PERM1IIT DOES NOT PRESUME TO <br /> GNE AVTHORITY TO VIGI.ATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> SUB TOTAL OFi THE PERFORMANCE CF CONSTRUCTION. <br /> PERMIT $ ,�• - <br /> TOTAL FEE 5 •� •� <br /> I - SIGNATVREOFCONTRACTOROFAUTH.AGENT DATE <br /> SIDEYARDSFj�TOACK STREETSE CK REARYq <br /> .J �;�R RP;SETBACK PLAN CIiECK NUM176ER PLAN CHECK FEE <br /> � '77�j ;3 FEE � PECEIPTNO. <br /> USEZONE ��1 LOTAREA VACANTSITE ?���• ' � CJ <br /> QVES ❑NO .'�n'�' T a <br /> FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELIING <br /> UNITS � <br /> I <br /> $SZ€�OF�3�OG. NO. Op 5 ORJES MA%.OCC LOAO <br /> L7)� aj(: `�r:j1C BUIL�ING 5 ' I .+.� V t /.� i: <br /> I <br /> FIRC- ZONE �ASEMENT F�qESPRINKLERS PWMBING ..'_�� '.t.' <br /> f f�:S RE�UIRED �[, <br /> ❑VES �,]NO MECHANICAL yl� �}�1 <br /> SPECIAL CONDITIONS: <br /> OTHER � � <br /> I <br /> PENELTV SEC.3071a) � <br /> TOTAL '•7 .;1 � <br /> . ..� . <br /> PERMIT VALIDATION <br /> VJHEN PROPEI7LV VALIDATED (IN THISSPACE)THIS IS VOUR PERMIT <br /> nl'�'IIC�iIONrICCCPTE011Y: VLANSCIICCKEOpY: pPPqOV[0lORISSIIANC[DY. <br /> .\.�_ . .. . . <br /> � <br /> y_..-1 <br />