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the Evergreen <br />CITY OF CONSTRUCTION everett <br />everett PERMIT <br />CITY HALL n9jUS <br />EVERETT. WASHINGTON <br />BRPDI <br />DEPE. OF COMMUNITY <br />DEVELOPMENT BUILDING MECHANICAL PLUMBING Lf�OWNER MAIL ADDRESS ZIP PHONEl'Obart D. $chuchard 2529 Maple 3ct?^i 252-.160aj�iX57I <br />ARCHITECT OR pESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />1112- 7 7 <br />GENERAL CONT KACTOR MAIL ADDRESS PHONE LICENSENO. <br />MECHANICAL CONTRACTOR MAIL ACIDFIESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />PERMIT <br />CLASS OF WORK � <br />❑ BUILDING ❑ PLUMBING ❑ MECHANICAL Z <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR - <br />VALUATIONOFWORK - .? <br />Ec <br />S E,3 00 ]DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL Li <br />DESCRIBE WORK -- C-_ <br />llen101ioh shad tYPe building 2825 <br />PROPOSED USE <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH TYPE OF FUEL ❑OIL ❑NAT. ❑LPG. ❑ELEC. <br />44 GAS <br />LOT1�PIES LOCK Bi3OF EVarett DiV al►' NO. TYPE OF EQUIPMENT _ FEE _ <br />44 AIR COND. UNITS-H.P. EA S 1 <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. 1 <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />.SS <br />FORCED AIR SYSTEMS-B.T.U. RI EA. <br />JOB a� ff,'-SS_oyt WALL HEATERS-B.T.U. .. <br />4411 H UNIT HEATERS-B.T.U. M 1 <br />P,UMBING EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />NO. TYPE OF FIXTURE OR ITEM FEE AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) g INCINERATOR <br />BATHTUB <br />LAVATORY (WASH BASI NI <br />SHOWER <br />KITCHEN SINK & DDISP. SUBTOTAL $ <br />DISHWASHER I <br />LAUNDRY TRAY PERMIT $ <br />CLOTHES WASHER TOTALFEE $ <br />WATER HEATER THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC" <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS. OR IF <br />,UgINAL CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />DRINKING FOUNTAIN PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />FI.00R-SINK OR GRAIN _ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />VACUUM BREAKERS PLICATIOi I AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />ROOF DRAINS-RAINLEADERS PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />_� OF WORK MILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />SINK (SERVICE -BAR, ETC.) OR NOT. THE GRANTING OF A PERMIT ODES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />SUB TOTAL .�_ <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />PERMIT $ <br />TOTAL FEE $ 7/5„7 <br />X <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT GATE <br />SIDE YARD SETBACK STREETSETBACK R EA R YARD SE TBACKPLANCHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE LOT AREA VACANT _SITE <br />OYES ONO FEES VALUATION FEE <br />TYPE OF CONST. OCCUPANCY GROUP NO. OF OW_EL LI NG <br />UNITS <br />SIZE OF BLDG' NO. OF STORIES MAX. OCC. LOAD BUILDING S • 1� <br />I <br />PLUMBING <br />FIRE ZONE BASEMENT FIRESPRINK LERS <br />REQUIRED <br />OYES ONO MECHANICAL <br />SPECIAL CONDITIONS: OTHER 1 <br />I <br />PENELTY SEC. 303(a) I <br />TOTAL 00 00 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />APPLICATION ACCEPTED BY: PLANS CHECKED BY. APPNOViO Fj 'ISSUANCE BY <br />S <br />crsT'3 •'•�^ <br />