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the =vcrg�cen � <br /> CITY OF CONSTR U�TION everett <br /> everett PERMIT <br /> ❑iY NALI 1y9 A6P5 <br /> EV[flE11,lVA5NINLiON <br /> IB:�I <br /> °"` "oE�f,�;M°„, BUILDING MECHANICAL PLUMBING <br /> OWNER MAIL AODRESS ZIP PHONE <br /> J.:t. 4try��.;^ 7i;� CS�;vn ji=?-?7 <br /> ARCHITECTORDESIGNEF MAILAD�RE55 PHONE LICENSENO. <br /> GENERA�CONTRACTOR MAILADORESS PHONE LICENSENO. <br /> ?:varett P.ufl:3ere 5§OG Everctruea t�tAq <br /> MECHANICALCONTRACTOR MAILADORESS PHONE UCENSENO. <br /> PLUM6ING CONTRACTOR MAIL ADORE55 PHONE LICENSE NO. � <br /> W <br /> m <br /> PERM�T CLASS OF WORK � <br /> ❑ 6UIlOING � PLUMBING �MECHANICAL Z <br /> ❑NEW ❑ADDITION ❑ALTERAT�ON ❑REPAIR ~ <br /> \'qLUAT�ON OF WORK <br /> � <br /> 5 JJ'-IO. C�� ❑DEMO�ISH ❑FENCE ❑SIGN ❑SWIMMING POOL W <br /> a <br /> DESCFIDE WORK ♦ <br /> P.s�::��CaS �!��i�llQ� - �at:l r�rl�.r �V�V <br /> PROPOSEO USE � <br /> MECHANICAL <br /> TYPEOf- FUEL �OI� QNAT. ��PG. �ELEC. <br /> LEGAL�E,".CRIPTION OF PROPERTY(SHOW �ELOW OR ATTACH GAS <br /> FOU R CO IF5) <br /> LOT �l OLOCK_oF ffarbor l�feto t�Q(�. NO. TVPEOFE�UIPMENT FEE <br /> Atfl COND. UNITS-Ii.P. EA. 5 � <br /> flEFRIGEFATION UNITS-H.P. EA. <br /> �OILERS-H.P, EA. � <br /> GAS FIREO A.C. UNITS-TONNAGE EA. <br /> FORCED AIR SYSTEMS-F3.T.U. M EA. I <br /> JOB ADDRESS WALL HEATERS-B.T.U. M I <br /> �!1� CSn47:1 JL�V� UNIT HEATERS-B.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTMES URYERS � <br /> VENTILATION FAN <br /> flANGEHOOD � <br /> NO. TYPE OF FIXTURE OR ITEM FEE AIR HANDLING UNI7- c.F.M. <br /> wATER CLOSET(TOILET) 5 INCINERATOR � <br /> �ATHTUO <br /> LAVATOqV(WASH BASINI ( <br /> SIiOWER <br /> KITCHENSINK& DISP. SUBTOTAL 5 � <br /> OISHWASHEF PERMIT 5 <br /> LAUNDflVTPAV — . <br /> CLOTHES WASHER TOTAL FEE 5 � <br /> THIS �'[RAt1T BECO�tES NULL AN� VOI� IF WORK OP CGNSTRUG <br /> WATER IiEATER TION AUTHORIZED IS NOT COMh7ENCED WITHIN 120 OA\'S, Ofi IF <br /> UFINAL CONSTRUCTION OR WORK IS SUSPFNDEII OR A�ANDONED FOR A <br /> DRINKING FOUNTAIN PERIOD OF 120 DAYS AT ANY TIME l�FTER WOFK IS COMMENCED. <br /> FLOOR-SINK OR ORAIN I HEREBV CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP� <br /> VACUUM �RLAKER$ PLICAiION AND KNOW THE SAM11E TO�E TRUE AND CORRECT. ALL <br /> fi00P �HAINS-RAINLEADERS PROVISIONS OF LAWS AND OFDINANCES GOVERNING THIS TVPE <br /> Of- WORK WILL BE COh1PLIE0 WITIi WHETHER SPECIFIED HEREIN <br /> SINK ISERVICE-DAR, ETC.) OR NOT, TFIE GRANTING OF A PFRMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAW PEGULATING CONSTRUCTION <br /> OR TH[ PERFORMANCE OF CONSTRUCTION. <br /> SUf3TOTAL <br /> PERMIT 5 �— <br /> TOTAI.FEE S �/2z/7.� <br /> x <br /> SICN4TUREOFCONTRACTORORAUTH.AGENT DATE <br /> SIDEVARDSETBACK STflEETSETBACK REARYAqOSETE3ACKPLANCHECKNUMBER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP NO.OF DWELLING <br /> UNITS � <br /> $IZEOFBLDG. NO. OFSTORIES MAX. 00C. LOAD BUILDING 5 -)f��n� '1� 3Eli CO <br /> - r— <br /> FIREZONE UASEMENT FIFESPRINKLERS ��UMBING i <br /> RE�UIRED <br /> ❑VES ❑NO MECHADJICAL � <br /> SPECIAL CONDITIONS: OTHER � <br /> I <br /> PENELTY SEC. 3031a) 1 <br /> TOTAL � ' � <br /> I <br /> I'ERMIT VALIDATION <br /> WHLN PROPERLV VALIDATED (IN THIS SPACEI TH1515 VOVR PEP�11T <br /> PPPLICAiIUN�LCIPi(UItY: 'LANSLHCLK(DOY: . FVVflOVEUfOPI.'.Sl1�NCF8Y. <br /> l�'�: <br /> 7 � <br /> ♦ <br /> � - � � � � _ <br />