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� thn Evergrecn <br /> ��TY o� CONSTRUCTION everett <br /> �verett PERNlIT <br /> [ilY Ndl� 1596855 <br /> tvtnEiL navuneiurv <br /> o31m <br /> ���� ��_���^����°r BUILDING MECHANICAL PLUMBING <br /> oE�E�o�,.,�•,� <br /> OWNER MAIL A�OFE55 21P PHONE <br /> t't�ttF Y^�i, h� 9 �U'"-�?:: 2�9-C�`7�. 55�-1G <br /> ,.. .:•� `.: <br /> ARCHITECT OR DESIGNER MAIL AOORE55 PHONE LICENSE NO. <br /> GENERALCONTRACTOR MAILADDRESS PHONE LICENSENO. <br /> :".S cY !• GC}�'']C F!'#� l'a bpt2� °22 �. SPy 223-��3�0 <br /> MECHANICALCONTRACTOR MAI�AODRESS PHONE UCENSE NO. <br /> PLUM9ING CONTRACTOR <br /> MAIL AO�RESS PHONE IICENSE NO. ��yJ <br /> m <br /> � <br /> PEFMIT CLASSOFWOFK � <br /> z <br /> [�[1UILOWG ❑PLUM6ING ❑MECHANICAL F- <br /> []NEW ❑ADUITION I]l�LT[RATION ❑REPAIH � <br /> � <br /> VALUATION OF WOR �y.� <br /> �tAI ❑DEMOlISH �FENCE ❑SIGN ❑SWIM1IMING PJOL W <br /> n. <br /> 5 <br /> DESCPIB@ WORK � <br /> ��" �'i ✓'�:'�''. I.!S �'.'i�.'. %'�?AR �.� '.tt.1�• '� <br /> PROPOSEL VSE MECHANICAL <br /> tvPEOFFUEI. �OIL �Gns. �IPG. �ELEC. <br /> I,EGAL DESCRIPTIDN OF PROPERTV ISHOW BELOW OR ATTACH <br /> FOUa COPiEs1 }� � NO. TVPE OF E�UIPMENT FEE <br /> LOT� ALOCK—�EOF 4.�.,FA fr'.Eaii3 - <br /> AIR COND. UNITS-II.P. EA. 5 � <br /> RGPRIGERATION UNITS-H.P. EA. —�— <br /> OOILERS-H.P. EA. � <br /> GAS FIREO A.C.UNITS-TONNAGE EA. <br /> FOFCED AIR SVSTEMS-B.T.U. M EA. � <br /> JO� AODRESS ,� WALL NEATERS-O.T.U. M <br /> �i�J�y� CL�iT.arK✓ UNIT `�E/1TERS-B.T.V. M � <br /> EVAPOFiATIVE COOLERS <br /> PLUMBING CLOTHES DFVERS � <br /> - VENTRATION FAN <br /> RANGEHOO � <br /> AIR HANOLING UNIT- C.F.M. � _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE INCiNERATOR � <br /> WqTER CLOSET ITOIIETI 5 <br /> BATHTUD - <br /> LAVATORY �WASHBASIN) I <br /> SHOWER _ <br /> KITCIiEN SINK& DISP. SUB TOTAL 5 I <br /> OISH4VASHER PERMIT 5 �— <br /> LAUNOftV TRAV TOTAI FEE 5 I <br /> CLOTIIES WASHER TMIS PEFAIIT 6ECOA1E5 NVLL AND VOID IF WORK `R CONSTRUC- <br /> WATE19 HEATER TION AVTNORIZ[O IS NOT COMh1ENC[D WITHIM1 120 DAYS. Oq IF <br /> UFINA� CONSiFUCT10N OF IVORK IS SUSPENDED OR AUANDONED FOR A <br /> PER.00 OF 1_0 OAVS AT ANV TIME AFTER WORK IS COMMENCED. <br /> ORINKINGFOUNTAIN <br /> FLOOR-S�NK OR DRAIN I HEREOV CERTIFY THAT I HAVE REAO AND E%AMINED THIS AP- <br /> PLICATION AND KNOW THE SAh1E TD OE TfiUE AND CORfiECT. AlL <br /> VACUUM OR[AKEiiS PROVISIONS OF LAV[S AND ORDINANCES GOVEfiNIIJG THIS TVPE <br /> ROOF ORAINS-HAIN�EADERS OF WDRK WILL �E COMPLIED WITH WHGTHLfl SPECIRED HEFEIN <br /> SINK lSERVICE-OI�F.ETC.) Ofi NOT, THE GRANTING OF A PEflA11T DDES NOT PRESVME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL TFIE PROVISIONS OF <br /> ANY OTHEF STATE OR lOC.1L LAW REGULATING CONSTRUCTION <br /> _ i_ OR TNE PEfiFORMANCE OF C,ONSTfiUCTION. <br /> SUBTOTAL <br /> PEflM1T S <br /> T0T.4LFEE 5 <br /> X � ChQt� �� <br /> SIGNATURLOFCONiHl�CTOROFiAUTH.AGENT DATE <br /> SIDFVARDSETUACK STREETSETI3ACK REAFiYARO5ET9ACKPLANCHECKNUA7R[R PLANCNECKFEE <br /> FG[ RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑VES ❑No FEES VALUATInN FEE <br /> TVPE OF CUNST. OCCUPANCV GROUP UNIOS DWELIING � <br /> .^IZE OF OLDG. NO.OF STORIES MA%. OCC. IOAD OUILDING S Q��� __�W <br /> PL111.1BING � <br /> FIFE20NE 6l�SGMENT fINESP(iINKLERS ._. � <br /> 9CQUIR�D � <br /> ❑YES ❑NO MECHANICAL � <br /> SPECIAL CONDITION 1: OTMER I <br /> I <br /> �— <br /> PENELTY C�Q S031a1 � <br /> I <br /> - TOTAL � <br /> - PERMIT VALIDATION <br /> WHEN PfiOPERLY VALI�ATED(IN THISSPACG) THIS IS VOUR P[RMIT <br /> I AfPLIC�tI0NF6CPTC�BV: PLANSCH[CNC�OY: RCPPOVEOFOP65U�NCEBY. <br /> �� <br /> .7 <br />