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� fhe Ever9reen . . <br /> ��T�oF CONSTRUCTlON everett <br /> everett PERMIT <br /> u�r Hnu is�teas <br /> rv�nm,wasxixcina <br /> 9e10i <br /> °`�` °"°""","„" BUILDING MECHANICAL PLUMBING <br /> uEv[larMEvi <br /> OWNEfi MAIL ADDRESS ZIP PFIONE <br /> i <br /> .�;� F'g� J:�"y ": �):.~:lY'ii 32y'G1� F��i'[�E 99 �'�'L 35� ];53.��X <br /> iAHCHIT[CT U(i DESIGNER MAIL A�DRE55 . ....._ L:CC':.r.0 :.... <br /> IGENERAL CONI HACTOR MAIL AD�RESS PHONE LICENSE NO. I <br /> 1^.��-pv 1�.'��•,� r� <br /> ... _l. <br /> A1hCHAAICAL CONTRACTOfl MAIL ADDRESS PHONE LICENSE NO. <br /> �`?�; cA`?S 'i A:'X!f.^i <br /> !'LLIAIUING CONTRACTOR MAIL AO�RESS PI10NE LICENSE NO. � <br /> W <br /> � T.f�� m <br /> ��� ,.�. <br /> PER�11T CLASS OF WORK � <br /> , <br /> z <br /> �OUIL�ING QPLUMOING �MECHANICAL � <br /> �EW ❑ADDITION ❑ALTEfiATION ❑REPAIR � <br /> VALUATION OF WORK — <br /> 5 �t���� ❑DEMOLISH ❑FENCE ❑SIGN []SWIMMING POOL W <br /> DESCRIBE WORK a <br /> a�r,:� s-��r.- ���zs.z c��ra.r,�m 1743 <br /> PROPOSE�VSE MECHANICAL <br /> TYPEOFFUEL �OIL �NAT. �LPG. �ELEC. <br /> LEGAL�ESCRIPTION OF PROPERTV ISHOW BELOW OH ATTACH GAS <br /> FOUR COI'IE5) <br /> Lo7� nLOCK—oF ��',�±� u,P� NO. TVPE OF EOUIPMENT FEE <br /> � AIR COND. UN�TS-H.P. EA. 5 I <br /> REFRIGERATION UNITS-H.P. EA. <br /> BOILERS-H.P. EA, � <br /> GAS FIRED A.C. UNITS-TONNAGE EA. <br /> FORCED AIR SVSTEMS-O.T.U. M EA. <br /> JOB ADDRESS '}���'�,��j WAL�HEATERS-O.T.V. M <br /> •'�` t�� �� �'��'a VNIT HEATERS-�.T.U. M I <br /> EVAPORATIVECOOLEFS <br /> PLUMBING CLOTHESDRVERS � <br /> VLNTILATION fAN <br /> RANGEHOOD � <br /> � TVPE OF FIXTURE OR ITEM FEE AIF IiANOLING UNIT- C.F.M. � <br /> � WATEfiCLOSETITOILET) 5 INCINEFATOR � <br /> � �ATHTUB <br /> LAVAI'ORY (WASH OASIN) � <br /> $HOWcR <br /> KITCNENSINK& DISP. SUB TOTAL 5 <br /> DISHVlASHEF <br /> PERMIT 5 <br /> �AUNDRV TRAY <br /> CLOTHESWASHER TOTALFEE S <br /> TNIS PERMIT BECOMES NVLL AND VOID IF VlOflK Ofi CONSTRUG <br /> WATER H[ATER TION AUTHORIZED IS NOT COMMENCEO WITHIN :70 DAVS, OR IF <br /> UqlflAL CONSTfiUCTIpN OR WORK IS SUSPENDED Ofi ADANDONED fOR A <br /> ONINK�NG FOUNTAIN PERIO� OF 12p �AVS AT ANV TIME AFTER WORK IS COMMEflCED, <br /> FLOOR-SINK OR �RAIN I IiERE�V CERTIFY THAT I HAVE READ AN� EXAMINED THIS AP� <br /> VACUUM OREAKERS PLICAt10N i1ND KNOW i HE;:AME TO BE TFUE AND CORRECT. ALL <br /> ROUF CIRAINS-RAINLEADERS PROVISIONa OF LA\NS AND OROINANCES GOVERNING TNIS TYPE <br /> OF WOFK WILL �E COMP�IEO WITH WHETHER SPECIFIE� HEREIN <br /> SINI: ISERVICE-DAH, ETC.1 OFl NOT, THE GRANTIN4 OF A PEqA11T OOES NOT PRESU�iC TO <br /> GIVE AUTHORITV TO VIOLAT[ OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL I.AW REGULATING CONSTRUCTION <br /> ORTHEPERFORMANCEOFCONSTRUCTION. <br /> SUB TOTAL <br /> PEqM1T 5 <br /> TOTAL FEE § �_ <br /> x ��� <br /> SIGNATUREOFCONTRACTGRORAUIli.AGENT DATE <br /> SIOE YA/RD SET�ACK 5'REET SETOACK fiEAR VARDSET�ACK PLAN CHpECK NUM�6ryE�R PLAN CIIECK FEE <br /> C�� �! � tt+Ri� a�uy�S FEE �(,t� RECEIPT NO. <br /> USE 2q(Jp,� LOT AREA VACANT SITE <br /> •j� �ES ❑NO FEES ��:�LUATION FEE <br /> T`.'PE OF CONST. OCCUPANCY GROUP NO.OF OWEIyING <br /> VNITS A � <br /> SIZE OF �L�G. NO.OF�S'±i�S MA%.00C. LOhD � BUILOING 5 a7M1F8NW � y�/ <br /> ��ra� <br /> PLUMOING <br /> FIFEZON pASEMENI FIRESPFINKLERS �� <br /> � 17Q,'�� REQUIFED ».� M <br /> ❑VES �NO MECHA��ICAL y.��,{/ <br /> SPECIAL CONDITIONS: OTHER � <br /> — I <br /> T <br /> PENELTV SEC.�0310) 1 <br /> 1 <br /> — TOTAL �;�,.a <br /> _ �i <br /> PERMIT VALIOATION <br /> — WHEN PROP[RLV VALIDATED IIN THISSPACE) TMIS IS VCUR PER�11T <br /> A�PLILnT1pNAfj.T'OBV: PLANSCHEC�7[.8�. APPPO�OFO(1�UANCEBY�. <br /> y� v s tr� � <br /> (1 <br /> •ti <br />