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r-- <br />MP Evergreen 4CO N S T R UOC T I FOR, <br />uTY of <br />everett PERMIT <br />DEPT. OF COMMUNITY DEVELOPMENT SERVICE$ <br />CITY HALL 259-874S /l�amT�I%�O G <br />EVERETT, WA98201 COMBINATION 4 BUILDING- ❑MECHANICAL ❑PLUMBING <br />n <br />MAIL ADDRESS <br />ZIP <br />4/ <br />PERMIT NO. <br />PHONE <br />C;2-5A-/.-/j9 -I <br />PHONE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 1 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSE <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION IVREPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />.S <br />PROPO usF OF Bu1LOINc <br />'T' <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNINII THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED I14REIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />J <br />LEGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT L_L is <br />V <br />Pn l� TA/1 n [J <br />O — 6 O -?0 — of P O <br />IOBADDRISS <br />PLUMBING <br />MECHANICA r <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />\S n1fR CLOSET ITOIIFTI — <br />AIR COND UNITS —HP EA <br />BATHTUB <br />REFRIGERATION UNITS—H P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS —HP EA <br />SHOWER <br />GAS FIRED A . UNITS —TONNAGE CA <br />KITCHEN SINK 8 DISP <br />FORCED AIR SYSTEMS—B T U M EA <br />DISWASHER <br />WALL HEATERS—B T U. M <br />LAUNDRY TRAY <br />UNIT HEATERS—BI U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS —RAINLE AGE RS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE —BA.. ETC I <br />SUB TOTAL <br />SUB TOTAL 3 <br />PERMIT S <br />_ <br />PERMIT y <br />TOTAL FEE S <br />TOTAL FEE Si <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PUN CHECK NUMBIR <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FIE <br />TYPE OF CONST <br />OCCUPANCY CROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />S <br />SIZE OF BLDG <br />NO. OF STORIES <br />MAX OCC. TOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />BEDROOMS <br />FIRE SPRINKLERS <br />REQUIRED <br />F1YIS ONO <br />MECHANICAL <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U tic <br />SIC 701(a) <br />2. BUILDING PLANS <br />l FIRE HYDRANT <br />TOTAL <br />A FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />S GRADINGIt%CAVATION 6CLEARINGIGRUBBING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPEL FOR ISSUANCE BY <br />