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rnc Ev�v�nrr,r <br /> ���� ,�� CONSTRUCTION everett <br /> everett PERMIT <br /> ,�,. ,�.�� :.,e. , <br /> ,,,,.�„ ,,..�,�.�,,�,� <br /> :,� <br /> °�°� °� �°°�•°'.��° BUILDING MECHANICAL PLUMBWG <br /> utvttorML•�i <br /> OWNE♦HtT] ���. /�, R1AIL AUONk55 21P PHpNL �j/��y�! <br /> MtYJ:e � 1/'i3al � 4.f.1!�. • 7�YG��y <br /> ARCHITECT OR DESIGNEH MAIL ADDRESS PHONE LIGENSE NO. <br /> GENERALCONTRACTOR MAILAODRE55 PHONE LICENSENO <br /> _��� <br /> MECHANICAL CONTRACTOR . MI11L AODFESS PHONE LICENSE NO. <br /> PLVMOING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. � <br /> ��y� W <br /> ..1 �Y:f.J'��.. �fN+�► � <br /> PLHAtIT CLASS OF WORK � <br /> ¢, z <br /> ❑�UILDING yJPLUMB�NG �MECHANICAL �EW . ❑ADD�TION r]I�LTERATION ❑REPAIR ~ <br /> � <br /> VALUATION OF WORK CL <br /> 5 ❑DEMOL�:11 ❑PCHCE ❑SIGN ❑SWIMMING POOL a <br /> DESCRIIIC WORK s�►nrr, �I ��L 81"t� .�� y:%.'p �� � <br /> ■'iw7./ 4�6 4 <br /> rnorosEo use MECHANICAL <br /> LEGALDESCFIPTIONOPPROPERTVISHOWBELOWOfil�TTACN TYVEpFFUEL �OIL �GnT. �LPG. �ELEC. <br /> FOUR COPIE51 <br /> Lor oLOCK—oF NO. __ TYPEOFEOUIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. 5 I <br /> REPRIGERATION VNITS-/1.P. EA. —� <br /> UOILERS- H.P. EA. I-- <br /> - � GAS FIRE�AC. UNITS-TONNAGE EA. —T <br /> � <br /> __ �FOfaCLD AIR SVSTEMS-B.T.U. M EA. I <br /> J0t3 ADORE55 Ar.At •!R� y,�y� �w WALL HEATEftS-B.T.U. M <br /> Cl�V C.vL:�:iJi �YZ/� --_ <br /> UNIT HEATCRS-�.T.U. M I <br /> EVAPORATIVE C'�OLERS —1 <br /> PLUMBING CLOTI�ES ORVERS I <br /> VENTILATION FAN �— <br /> RANGEHO00 I <br /> TVPE OF FIXTURE OR ITEM FEE nIR HANOIING UNIT- C.F.M. <br /> WATERCLOSETITOILETI 5 �NCIi�cRATOR _ I <br /> � unn�rua � — <br /> LAVATORY IWASII DASINI � � __ <br /> _ SHOWGR ___ <br /> KITCHEN SINK & DISP. $Ufl TOTqL S � <br /> DISHWASH�ri _ PERMIT S <br /> LAUNDRV TfiAY _ TOTAL FEE S I <br /> CLOTIIES WASMER THIS PERAIIT f3ECOMES NULL AND VOID IF WORK OR CONSTRUC- <br /> WATER HEATER __ TION AUTMORIZE� IS NOT COAIMENCEO WITNIN 140 DAYS, Oli IF <br /> UliINAL CONSTRVCTION OR WORK IS SUSPENDEO OA AOANOONED FOR A <br /> DHINKING FOUNTAIN -} — PEHIOD OF 120 DAVS AT ANV iIME AFTER WORK IS COMMENCEO. <br /> FLOPR--SINK OF ORAIN —� I HEREF3Y CERTIFV THAT I HAVE READ AND [XAM1IWED iH15 AP� <br /> VACUUM1I IIREAKERS � PLICATION AN� KNOW THE SAME TO BE TFVE AND CORREGT. AU. <br /> ' ROOP pRA1N5-RAINLEADERS —{— PROVISIONS OF LA\YS AND OFDINANCES GOVERNING THIS TVPE <br /> OF WORK WILL UE COAIPLIE�WITII WHETHEFl SPECIFIG� HEfiEiN <br /> SINK ISERVICE-fl!•F. ETGI �— OR NOT, THE GRANTWG OF A PERMIT �OE; NOT PPESUME TO <br /> �--� ---I--'�-- GIVE nUTNORITY TO VIOLATE OH CANCEL THL PROVISIONS OF <br /> �- -- -- ! - �� — nNY OTHHH STATE OR LOCAL LAIV FGGULnTING CONSTRUCTION <br /> —_ __�_ _ ORTH6P[iiFORM4NC[OFCON:IRUCTION. <br /> SUOTOTAL <br /> — PERMIT 5 _. �{ . . . .. . <br /> TOTAL FEE S ��r � <br /> ,i � x � cneeQ �L' 3/3N7b <br /> SIGNATUfiEOF CONT(iACTOHOR AUTM.AGENT DATE <br /> SIUEVARDSET�ACF STREETSGTf3ACK FEAHVAROSETUACKPLANCHECKNUM�ER PLANCHECKFEE <br /> PEE RECEIPT NO. <br /> U.�.E LONE LOT AREA VACANT SITE <br /> ❑vEs ❑rv0 FEES VALUATION FEE <br /> ivvE OF CONST. OCCUPANCY GROUP UNIOS DWElL1NG ' <br /> � <br /> SiLC�OF 6lOG. NO.OF STOHIES MAX.00C. IOAD BUILDING S � <br /> 1 <br /> t <br /> PLUM�ING <br /> i PIHEZONE �BASEMENT pCOEUIREDKLLftS � <br /> 'I . ❑VES ❑NO MECl/ANICAI . . I — <br /> SPCCIAL CONOITIONS: OTHER � <br /> I <br /> PEN[LTY SEC. 9071:i1 � <br /> i _ _ ____f—_ <br /> I <br /> TOTAL <br /> �J � <br /> PERMIT VALIDATION <br /> � V�HEN PqOP[RI.Y VALIDATED IIN THiS;PqC@1 THIS I` YpUfi PLRLIR <br /> � <br /> � <br /> � <br /> nW��Ulil ACCLi'ilUOY PL�IISOI[CREpPY P�PIIpyfUfO1�L':UAf.pIbY . <br /> j � � � C� <br /> � a � <br />