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thc Everyicrn <br /> ���� ��� CONSTRUCTION everett <br /> � eVCI'ett PERMIT <br /> I fvfxV�t W�Su�Y':�ny <br /> lal ll <br /> °"' °""""°',", gUILDING MECHANICAL PLUMBING <br /> o�v[lnrVp�t <br /> OWNER MAIL Af)OfiE55 ZIP P110NL <br /> Jo:►n F. Skyta 2411 ::v,arott Avenucs 95201 2:?-373� 91�-77 <br /> ARCHITECT OH OESIGNER I.tAIL Af]DfiE55 PMONE UCENSE NU. <br /> GENERALCONTHACTOR MAILAUORE55 PMONE LICENSE NO. <br /> sar� <br /> MECHANIC�1l CONTNACTOR MAIL AD�flESS PHONE LICENSE NO. <br /> PLUMOING CONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. � <br /> W <br /> m <br /> � PERMIT CLASS OF WOHK � <br /> z <br /> �.OUILDING �PLUMBING �MECHAN�CAL I- <br /> ❑NEW ❑A�DITION ❑ALiEIiATION ❑REPAIR � <br /> VALUATION OF WORK � <br /> s SVO�DO . ❑DEh10Li5H ❑F[NCE ❑SIGN ❑SWIMMING POOL a <br /> DESCPBE WORK <br /> Raplaae Poo:a - Founc:atioa 2729 <br /> PROPOSE�VSE MECHANICAL <br /> TYPEOFFUEL �OIL �NAT. �LPG. �ELEC. <br /> LEGALp DpESC9R1IPTION OF PROPERTV ISMOW UEIOW OR ATTACH GAS <br /> ��Yp 1���1�J 604 �rerett Uiv. 1 NO. TYPE OF EOUIPMENT FEE <br /> LOT BLOCK_OF AIRCOND.UNITS-H.P. EA. S I <br /> REFRIGERATION UNITS-H.P. EA. <br /> BOILERS-N.P. EA. I <br /> GAS FIHED AC. UNITS-TONNAGE EA. <br /> FORC[D AIR SVSTEMS-A.T.U. M EA. 1 <br /> JOB ADORESS WALL HEATERS-B.T.U. M <br /> 'Z�IZ �+�r4tt �OQn1�1 UNIT HEATERS-B.T.U. M I <br /> BVnPORnTIVE COOLERS <br /> PLUMBING CLOTM[SORVEFS I <br /> VENTILATION FAN <br /> RANGENOOD 1 <br /> NO. TYPE OF FI%TURE OR ITEM FEE AIR HANDLING UNIT- C.F.M. <br /> WATER ClOSETITOILETI 5 INCINERATOR � <br /> T <br /> OATHTUB �. <br /> LAVATORY IWASH BASINI T_ I <br /> �"'1WER <br /> �- <br /> KITCHEN SINK& DISP. SUEt TOTAL $ .� <br /> DIStIWFSHER PERMIT 5 <br /> LAUN�IIY TRAY TOTAL FEE 5 � <br /> CLOTHES WASHER � THIS PERMIT OECOMES NULL AND VOID IF WORK OR CONST(7UC <br /> WATER MEATER TION AUTHOA�2ED IS NOT COA1h1ENCED WITNIN 120 DAVS, OR If <br /> UFlINAL CONSTRUCTION OR WORK IS SUSPENOEO OR AUANDONED FOfi A I <br /> DRINKING FOUNTAIN PERIOD OF 120 DAYS AT ANV TIME AFTER WOPK IS COh1MENCEO. <br /> FLOOR-SINK OR ORAIN � MEREBV CERTIFY THAT I HAVE READ AND E%AMWEO THIS AV <br /> VACUUM OREAKERS PUCATION AND KNOW TME SFM11[ TO DE TRUE AND CORRECT. ALL. <br /> POOF DRAINS-RAINLEA�ERS PRO\'ISIONS OF LAWS AN� ONOINANCES GOVERNING THIS TVP� <br /> OF WORK WILL BE COM1iPLIED WITM LYIiETHER SPEGFIED NERfIN <br /> � SINK (SEflVICE-UAR.ETC.) OR NOT. iHE GRANTING OP A PERMIT DOES NOT PfiESUhtE TO <br /> GIVE AUTMOflITV TO VIOLAiE OR CANCEL TNE PROVISIONS OF <br /> ANV OTHER STATE OH LOCAL LAW FEGULAT�NG CONSTfiUCT10N <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SUB TOTAL <br /> PERMIT S <br /> TOTALFEE S ��17��]7 <br /> X <br /> SIGNATUREOFCONTRnCTORORAVTH.AGENT OATE <br /> I SIDEVl1RDSETOACK STREETSETOACK. REARVAPDSETF3I�CKPL/1NCHECKNUM6ER . PLANCHECKFEE <br /> FEE HECEIPT 40. <br /> iUSE 20NE LOi AREA VACANT SITE <br /> � ❑vE5 ❑No FEES VALUATION FEE <br /> TVYE OF CONST. OCCUVANCV GROUP NO.OF�WELLING <br /> UNITS I <br /> 512E OF ULDG. NO.OF STORIES MA%.00C. LOAD DUILDING S SOD�OO S i O:� <br /> _t__ <br /> PLUMBING � <br /> I FIHE 2UNE OASEAIENT FIRESPRINKLERS � <br /> REOUIRED <br /> I - � ❑YES ❑NO h7ECHANICAL � I <br /> �� SPECIALCONDITIONS: OTNER � I <br /> i i <br /> PENCLTV SEC.JOJId � � <br /> - i <br /> TOTAL j�^ I <br /> PERMIT VALIUATION I <br /> YIMEN PROP[RL.� b'ALIOATEO IIN THI$SPnCEI TNIS IS 1'OUq PERMIT <br /> 1 <br /> i — I <br /> �i�li'A1.. .� I�i•I'�Il� �Iz'IiCM�flf�iXY ♦�i'Pfl'.Itll�li��i ..:�( !1♦ - I <br /> I `••t � I <br />