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, <br /> the Evergreen C ON S T�i U CTI 0 N <br /> �„_� �,�, everett <br /> everett PEH��T <br /> CITY IIALL2�9g74v <br /> cveaeTr, wn sazoi COMBINATION • RllILDING • MECHANICAL • PLUMBING <br /> OWNER A1AILl�UDH[::5 ZIP PHONE � <br /> 0. K. 2-i�LT?lIII30T1 <br /> m <br /> AFiCHITECT OR OESIGNER MnIL ApDR6S5 PHONL LICENSE NO. � <br /> � <br /> � <br /> GENERALCONTRAGTOfi MAIL AODRESS PHONE LICENSE NO. <br /> SOUiiD DLDG. �: It�fOD�I,3iNG 252-4920 c <br /> MECIiANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE ND. � <br /> W <br /> <;� m <br /> PLUM�ING CONTRACTOR MAIL AOORESS PHONE LICENSE NO. .,,�i � <br /> �J <br /> PERMIT CLA55 OF WOflK CD <br /> �COMBINATION <br /> � �UILDING � PLUMUING �MECIIANICAL <br /> ❑NEW ❑ADDITION ❑ALTERATION �REPAI(i <br /> VALUATION/ OF WORK — — - <br /> QUQp�� ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMh:INC. POOL <br /> 5 <br /> OESCRIBE WORK <br /> .��1�.�,�i�I!' �C.QI''�� <br /> PROPOSED USE <br /> MECHANICAL <br /> LEGAL UESCRIPTION OF 1'ROPERTV ISIIUW E3ELOW OR ATTACIi TrPE OF ENERC;Y <br /> f-OUFCOPIESI ❑CAS ❑ELEC. <br /> Lo72.3a� pLOCK�'_oP�',yA]j�'y;$�s} NO. TVPE OF E�UIPMENT FEE <br /> AIR COND. UNITS-�H.P. f:l�. 5 I <br /> AEFRIGERATION VNITS H.P. E11. <br /> f301LER5-H.P. En. � <br /> FORCED AIR SVSTEMS-l�.T.U. MEA. <br /> _ I <br /> JOB ADOfiESS SPACE ri WALL HEATERS - B.T.U. <br /> �102�{ FRID.IY -- uNiT ritnrer�s-u.r.u. i <br /> evnvonntiv�coo�ens <br /> PLUMBING -- c�ornes onvens i <br /> VENiILATION FAN T <br /> RANGEHOOU � <br /> NO. TYPE OF FIXTURE OR ITEM FEE niR HANOLING VNrt- C.F.M. <br /> RATH TUBS �— --"- <br /> CLUTHES WASHER � -- —— � <br /> DISH WASNERS i __ �'�'ATEfi HEATER <br /> DRINKING FOUNTAIN$ � __ FAC. OUI�T NREPLACE & CHIMNEV � <br /> GAS. SYSTEM: NO OP OUTLETS —�- <br /> FLOOR DRAINS � _ _ <br /> KITCHEN SINKS & DISP. � SUo TOtnL 5 j <br /> BAR SINKS � PEqMir 5 <br /> ROOF DRAINS - RAIN LEADERS � TOTnI FF.G 5 � <br /> SHONiER BATHS THIS PCRM111i 9[COMES NVLL AIJD VOIO IF WOPK OR CONSTRUC <br /> SEHVICE SINKS TION AUTIIOIIIZ[U IS NOT COMMhNCE� WITHIN 120 DAVS, OR IF <br /> SUMPS - SEWl1GE PU�'P CONtiTRVCt10N OR WORK IS SUSPENDLD OR A[3AfJflONED f0(i A <br /> URINAl.S i �'ERIOU OF 120 DAYS AT ANV TIME AI°TER WORK IS COMMENCED. <br /> WATER CLOSETS I I HEREIIV CERTIFV THAT I HAVE RCAD AND E%A411NG0 THIS AP� <br /> PLIGATION AND KNOW THE SAM@ TOliE TF1U[ AND COPRECT. !LLL <br /> WATER HEATERS - ELECTRIC � vrvoviSioN; oF �nWS AND OfiDINf�NCES GOVERNING THIS TVPE <br /> WASH E3ASINS � Of WOflK WILL Ul COAIPLI[D WITII WHETIIER SPECIPIE� HEREIN <br /> LAUMDHY TRAYS nq NOT, TH[ GRANI'ING OF Il PERMIT DOE$ NOT PH[SUME t0 <br /> � � GIVE l�UT110l�ITY TO VIOLATE OR CI�NCEL TNL PRpVI510N5 OF <br /> ANV OTIIFER ST/liE OR LOCAL LAW qLGULATING CUNSTRUCTION <br /> � OH Tn[ P[EIiPOHMANC[ Of CONSiRUCTION. <br /> SUf� TOTAL i <br /> PERMIT 5 i <br /> 70TAL FEE —� x � � 9/2'1/77 <br /> WATERSEHVICESIZE f3LDG. SUPPLVSIZG Sic uR -orCONrnnC ononnUiH.nceN7 DnTE <br /> SIOEVAROSETOACK STR[ETS[TRACK RLARYl�RDSETQACKPLAN�HECKNUMBI'H PLANCHECKFEE <br /> f-[E REC[IPT ND. <br /> USE 20NE LOT AREA Vl�Gl�NT SITE <br /> . ❑vE5 ❑No F[ES VALUATION fEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF�WELLING <br /> UNITS � <br /> SIZ[OF RLDG. NO.OF STORIES MAX.00C. LOI�D UUILDING 5 2600�00 � <br /> FIRL20NE UAS[MENT FIHGePHINKLERS rWM01NG i <br /> REOUIRED I <br /> ❑VLS ❑NO M[CHANICAL � <br /> SPECIAL CJNDITIONS: OTHER � <br /> � <br /> � PENALTV SEC.�OSIaI I <br /> TOTAL �4 ��� � <br /> PERMIT VALIDATION <br /> — wi�en r�ieorei�i v vnuonreo nN nus sPncn� r�us is vouiv r�r�mit <br /> -- 0764 S�J14. DO Tor�. —. <br /> -- — , :`, <br /> �i;l. <br /> �:Y <br /> _--_ ' L ' <br /> rcatrR RFc���-r '. <br /> ami.�rnnor�neetr�euin rine�u:mcn�uur nrvnovioroni;sunrvetm . <br /> 1.�. 7HANK YOl1 <br /> � <br /> —ti -. <br />