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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598885 <br />EVERETT. BIASHINGTON <br />98201 <br />OEPT. OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e�� <br />OWNER MAIL ADDRESS ZIP � PHONE <br />9 TA" 7333 TIM TiM J= 39-3745 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />Lon. 9mmy 4 AMC. <br />TE> <br />y� �►�/MAIL ADDRESS 8�P1�HO/NEEB}L LICENSE NO. <br />GENERAL le <br />cm i8 Ahem TMM �GiT � or GJG�RJLi✓ 1F1T <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cc <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />I- Cpcts! <br />m <br />E <br />PERMIT <br />BUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />M <br />z <br />~ <br />VALUATION OF WORK <br />$ito <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />� <br />C <br />DESCRIBE WORK/y) <br />(DUO um <br />1320 <br />PROPOSED USE <br />�t h �' <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑GAAS. ❑LPG. ❑ ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR.WPIFS) VIM Ai+ <br />LOT JIi SLOCK_OF <br />— <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />$ 1 <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 />JOB ADDRESS <br />` <br />�.M T"AIV fifts = <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 />AIR HANDLING UNIT— C.F.M. <br />O. <br />TYPE OF FIXTURE OR ITEM <br />F <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 S <br />I <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTALFEE $ <br />I <br />CLOTHES WASHER <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 />'ERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 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 L2��Ci��'IV <br />WATER HEATER <br />`URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS AINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />$ <br />TOTALFEE <br />$ <br />_ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />ISTREETSETBACK <br />REAR Y�yA�RDSETBAC <br />20 <br />PLAN yI �CHE�CK NUMBER <br />+&A4C* <br />py�PLAN CHECK FEE <br />FEE�{� RECEIPT NO. <br />I.WiBa- 6- <br />USH ZONE <br />102 <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OS DWELLING UNITI <br />BUILDING <br />$ <br />XW OD <br />1 <br />SIZE OF BLDG. <br />NO. OfISTORIES <br />4 <br />MAX. OCC. LOAD <br />PLUMBING <br />1OD <br />FVRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />AFOUIRED <br />DYES ONO <br />MECHANICAL <br />1 <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENELTY <br />SEC. 3031.) <br />TOTAL <br />��oryy1 <br />PERMIT VALIDATION - <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />APPLICATION ACCEPTED BY: <br />M <br />FLANSCHECKEDBY: APPNOVEDFOF <br />t!/N <br />ISSUANCE BY: <br />Tv <br />7v <br />