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the Evergreen <br />CI I OF <br />everett <br />CITY HALL 2590885 <br />EVEBETT. WASHINGTON <br />98201 <br />OEPT. OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNER MAIL <br />f MAIL ADDRESSZIP <br />���y�r..l� ZIP PHONEY <br />ill J ::Y✓ qr. TrTi 'm P. v 5 FY[T+ illumw <br />�'�'Ei <br />152cwm <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />M 3AL "Is Vr- 7U12 <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />As 13[37'-XAM <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />m <br />LU <br />m <br />PERMIT <br />L <br />TDBUILDING tIPLUMBING ❑ MECHANICAL <br />CLASS OF WORK <br />.1YL)y�amF�,, <br />NEW El ADDITION El ALTERATION [-IREPAIR <br />Z <br />VALUATION OF WORK <br />$ <br />El DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />d <br />DESCRIBE WORK <br />_ <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑NAT. ❑LPG. ❑ELEC. <br />GAS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOU <br />LOT,""'^ BLOCK WOF rvr-vw my, <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P, EA. <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />I <br />JOR ADDRESS �! � <br />WALL HEATERS-B.T.V. M <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />O. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) <br />$ <br />INCINERATOR <br />I <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUBTOTAL $ <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTALFEE $ <br />1 <br />CLOTHES WASHER <br />WATER HEATER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />FERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />CATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <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 />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />IPLI <br />ROOF DRAINS-RAINLEA DE RS <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />$ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YWD SETBACK <br />STREETSJJJACK <br />REAR VAOJETBACK <br />PLAN CHECK NUMBER <br />76" <br />PLAN CHECK FEE <br />FEE �yx _may RECEIPT NO. <br />USE ZONE Ty <br />LOT ARJ J= <br />j'�� <br />VACANT SITE <br />15yES ONO <br />FEES <br />VALUATION <br />FEE <br />T F CONST. <br />r <br />OCCUPANCY GROUP <br />� <br />NO. OF DyR� ELLING <br />UNITS Y <br />I <br />BUILDING <br />5 140s TOO <br />moo <br />SI G. <br />NO. OF SjfRIES <br />MAX. OCC. LOAD <br />PLUMBING <br />Fill ZONE <br />BASEMENT <br />FIRESPRINKLLERS <br />REQUIRED <br />❑VESnNO <br />MECHANICAL <br />j <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />i <br />PENELTY <br />SEC. 303(a) <br />I <br />TOTAL <br />LOD <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />fl <br />APPLICATJO(ISCCEPTEU BY: <br />1S§i <br />PLANSED BY: APPNOVR <br />ttttttVVVVVV <br />l <br />ISSUANCE BY <br />— <br />