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the Evergreen <br />CITY OF <br />everett <br />CIT( HALL 259BUS <br />EVERETT. WASHINGTON <br />98201 <br />OEW. OF COMMUNITY <br />BUILDING <br />DEVELOPMENT ELUPYEN <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �.e <br />OWNER MAIL ADDRESS ZIP PHONE <br />ARCHITECT OR DESIGNER MAILADDRESS PHONE LICENSE NO. <br />GENERALCONTflACTOR MAIL ADDRESS PHONE LICENSE NO. <br />smP <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />in <br />D <br />PERMIT <br />�1, <br />CbUILDING []PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />Z <br />j— <br />VALUATION OF WORK <br />S <br />If DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />cc <br />LU <br />DESCRIBE WORK <br />��� JJiRV <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL [:]OIL (-]GNAT. []LPG.❑ ELEC. <br />LEGAL DES!"•IPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIL-F.? <br />LOT_. - BL.00K_OF <br />m" ry'a eB�� aw fl +d/ylE� <br />Jtl:i'►+ l[f E* ice' ifKtwoW IfH� <br />NO. <br />TYPE Or EQUIPMENT <br />_ <br />-EE <br />AIR COND. UNITS-H.P. EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />I <br />JOB A❑ORESSpir, <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) <br />S <br />INCINERATOR <br />I <br />BATHTUB <br />LAVATORY IWASHBASIN) <br />SHOWER <br />KITCHEN SINK &DISP. <br />SUBTOTAL S <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTAL FEE $ <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 15 SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <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 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 />x <br />URINAL <br />DRINKING FOUNTAIN <br />_ <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />g <br />TOTALFEE <br />$ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO.OF DWELLING <br />UNITS <br />BUILDING <br />'EN� <br />S VNVyW <br />��FFyy�yII �My� <br />«W <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAD <br />PLUMBING <br />I <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />❑ ONO <br />MECHANICAL <br />j <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />I <br />PENELTY <br />SEC. 303 (a) <br />I <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />Q <br />APPLICATION ACCEPTED BY: <br />PLANS CHECKED BY: APPROVED <br />FOA ISSUANCE BY: <br />Zw Q+ <br />