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7he Evergrcen <br /> =�T�oF CONSTRUCTION everett <br /> everett PERMIT <br /> QiY11411 }59FF35 <br /> EV(NE11 IYASNIN610N <br /> 99101 <br /> °`°` °"°"°'°�"" gUILDING MECHANICAL PLUMBING <br /> _ a[vc�ovu[qt <br /> OWNER MAIL AD�RESS 21P PMONE <br /> Ei1t*..1h�9, Lrr.eat 6311 Cyprass �trz�t 3�3—�128 <br /> ARGMITECTORDESIGNEfl MAILAODFE55 PHONE LICENSENO. I�.IL"�J�I <br /> GENERAL CONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. <br /> MECMANICAL CONTRACTOR MAIL AODRE55 PHONE LICENSE NO. <br /> PLUMBING CONTRACTOR MAIL ADDRE55 PHONE LICENSE ND. � <br /> W <br /> m <br /> PEFMIT CLASS OF WORK � <br /> u�UILDING �PWMB�NG �MECHANICAL z <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ~ <br /> VALUATAN OF WORK � <br /> 5 9i. ��JD ❑�EAIOLISH ❑FENCE ❑SIGN ❑SWIMMINGPOOL W <br /> G. <br /> OESCRI�E WORK <br /> er�ec �z�x23� c.�rport 2984 <br /> � ' <br /> � PROPOSED USE <br /> � c,<�••.:nrt MECHANICAL <br /> � TVPEOFFUEL �011. QNAT. �LPG. �ELEC. <br /> LEGAL DESCRIPTION OF PROPERTV (SMOW BELOW OR ATTACH GAS <br /> FOV R CO 1€SI <br /> LOT �� BLOCK_oF rLG'�p ��y�Q� NO. TVPE OF EUUIPMEN7 _FEE <br /> AIR COND.UNITS—H.P. EA. 5 I <br /> REFRIGERATION VNITS—H.P. Eq. <br /> �OILERS—H.P. EA. � <br /> GAS FIRED A.C. UNITS—TONNAGE EA. <br /> FORCED AIR SVSTEMS—�.T.U. M EA. I <br /> JOB ADDR 5 WALL HEATEHS—B.T.U. M <br /> 63�1'� Cy�,rrec. ,^>trrs;,k <br /> UNIT HEATERS—d.T.U. M I <br /> EVAPORATIVECOOLEHS <br /> PLUMBING CLOTHES ORYEPS <br /> i <br /> VENTILATION FAN <br /> RANGEHOOD � <br /> NO. TVPE OF FI%TURE OR ITEM FEE /+�A HANOLING UNI7— C.F.M. <br /> WATER CLOSGT(TOILETI g �NCINERATOR � <br /> BATHTVD <br /> LAVATORY (WASH BASINI � <br /> SHOWER — <br /> KITCHEN SINK& DISP. SUO TOTAL $ � <br /> DISHWASHER PERM1IIT 5 <br /> LAUNDFYTRAY <br /> CLOTHESN'ASHER TOTALFEE 5 � <br /> iN15 PERMIT BECOMES NULI l�ND VOID IF WORK OR CONSTRUC� <br /> WATGl� HEl�TER TION AUTHOR12E0 IS NOT COMMENCE� WITHIN 120 �AVS, OR IF <br /> UqINAL CONSTRUCTION OR WORK IS SUSPENCED OR A6ANDONED FOR A <br /> �RINKING FOUNTAIN PEFIOD OP 120 DAVS AT ANY TIME AFTEfl WORK IS COMMENCEO. <br /> F�ppR—SINK OR DflAIN I IIEREBV CEFTIFV THAT I HAVE READ ANO E%AMINED THIS AP� <br /> VACUUM OREAKERS PLICATION AND KNOW THE SAME TO �E TRUE AND CORRECT. ALL <br /> ROOF DRAINS—RAINLEADERS AROVISIONS OF LAWS AND OflDINANCES GOVERNING THIS TVPE <br /> OF WORK WIIL BE COMPLIED WITH INHETHEli SPECIFIEO HEFEIN <br /> SINK (SERVICE—(3AR, ETCJ OR NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTH[R STATE OR LOCAL LAIV (9EGULATING CONSTRUCTION <br /> - OF THE PERFOHMANCE OF CONSTRUCTION. <br /> SU� TUTAL <br /> PERMIT 5 <br /> l'OTALFEE $ �I1I77 <br /> x <br /> SIGNATUREOFCONTRACTOROPAUTIi.AGENT DATE <br /> SI�EYARDSETBACK STREETSET[3ACK REARYqRDSETOACKPLANCHECKNUMBER P�ANCHECKFEE <br /> FEE RECEIPT NO. <br /> USEZONE LOTAREA VACANTSITE <br /> �vEs ❑No FEES VALUATION FEE <br /> TYPE OF WNST. OCCUPANCV GROUP NO.OF OWELLING <br /> UNITS � <br /> � t . i. � . <br /> SIZE Of BLOG. NO.OF STORIES MAX.000. LOAD �UILOING $ � <br /> PLUMOING � <br /> FIREZ9NE BASEMENT FIRESPRINKLERS <br /> RC�UIRED � <br /> ❑YES ❑NO M1IECHANICAI. � <br /> SPECIAL CONDITIONS: OTHER � <br /> 1 <br /> P[NELTV SE0.903(a) I <br /> TOTAL �� <br /> I <br /> PERMIT VALIDATION <br /> WHEN PROPLRLY VALI�AT@D IIN l HIS SPACE)THIS IS YOUR PERAi1T <br /> nPPIJCntION�UC1`1ED01'. PL:dLCHECRfOBY'. APPPOVEOFO(il$$VANCCOY. <br /> � <br />