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� thc Evergr_�en <br /> I CONSTRUCTION r � <br /> `�TY °F eyerett <br /> i eve,��tt P�RMIT <br /> ��,. ,,.:<< �.��ea3� <br /> , E�,�.,,r �.�a=„�.,�r�., <br /> � �a�.� <br /> °`°' °` `°'"'°'°" BUILDING MECHAh'ICAL PLUMBING <br /> uevciovuc;i mni�nooaess ziv <br /> OWNEP <br /> PHONE <br /> its`�"A� ?i� tp�'�,r�"`� • �� ::'• � T.'Y:: r'Y'T 3�'�2� �"�`i� <br /> nRCHITECTOPDE5IGNER A9AILAD�qESS PHONE <br /> UCENSE NO. <br /> GENEPALCONTRACTOR MAILAODRESS PHONE <br /> �j���,� '`�-' LICEN�SE N9. <br /> V1A!"i.�+'c:�+J"S�:),r:..� <br /> LIECHANICALCON'�ftACTOR MqIL :,DDflESS PHONE <br /> LICENSE NO. <br /> f _UMOING CONTP,1rTOR M41L ADORES.S PHONE � <br /> LICENSE NO. W <br /> PERMIT --- -- m �� <br /> C 1A55 OF WORk � <br /> � <br /> �]6UILDING '] z <br /> ❑ PLUM�IN. �MECHANICAL y� r <br /> LJNEW ❑qDDITION ❑ALTERATION ❑REPqIR <br /> VA�UATIONI1Of-WORK � <br /> S �`y:�� I ❑DEMOLISH ❑FENCf r]SIGN ❑SWIMMING POOL W <br /> OESCRIB[WORK y�+y }y�qy ( -- d <br /> �.���'.� •�•:"! :.St�f.,.....,. r. ',"d.,.� L6]'t.'i'..�jYL' <br /> PFOPOSED USE <br /> 217 <br /> MECHANICAL <br /> LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH TVPE OF FU@L CiL NAT, <br /> ❑ ❑ �LPG. �ELEC. <br /> FOUR PIE51 GAS <br /> �aT � B!ocK—oF ����' ���il F�A':�C NO. TVPE OF EDUIPMENT FEE <br /> AIR CONO. UNITS-H.P, Eq, 5 � <br /> FEFRIGEqATION UfvITS-H.P. EA. <br /> BOILERS-H.P, EA. � <br /> GAS FIHcD A.0 VNITS-TONNAGE EA. <br /> FOPtED AIF£ 'STEMS-B.T.U. M EA. � <br /> JO� ADDRESS -��-- <br /> '��XJ1 �+rt_ J4f��r'!!:IVYI WALL HtATERS-6.T.U. M11 <br /> J�a _ �Ki <br /> UNIT H�ATERS-B.T.U. M I <br /> PLUMBING EVAPORATIVECOOLERS <br /> CLOTHESORVERS � <br /> VENTILATION fAN <br /> RANGEHOOD � <br /> NO. 7VpE OF FIXTCRE OR ITEM FEE �AIR HANULING UNIT- p,F.M. <br /> WATER CLOSET�TOILCI) S INCINERATOR � <br /> OATHTUB <br /> LAVATO�iY IWOGH 3ASIN1 <br /> SHOIYER _ I <br /> KITCNEN SINK& DISP. <br /> DISHWASHER SUB TOTAL 5 � <br /> LAUNDRY TRAY 7ERMIT $ <br /> _ CLOTHESWnSHER TOTALFEE S � <br /> WATER HEAiER THIS PERMIT BECOMES NUL(. ANO VOID IF WORK OR CONSTRUC- <br /> URINA� . TION AUTHORI2ED IS NOT COtdMENCED WITHIN 120 DAYS, OR If <br /> — CONSTfiUCTION OR WORK IS SUSPENDED OR A�ANDONE� FOFt A <br /> DRINKING FOUNTAIN PERIOD OF 120 �AVS AT ANV TIME AFTER WORK IS COMMENCED. <br /> FLOOFl-51�4_Oq ORIVN I HERE6V CERTIFY THAT I HAVE READ ANO EXAMINED THIS AV- <br /> _ VACUUh1 BqEAKERS PLICATION AND KNOW'fHE SAA1E TO �E TRUE ANO COfiFECT.ALL <br /> ROOF DRAINS-RAINLEADERS PROVISIONS OF LAWS AND ORDINANCES GOVEFNING THIti lVP[ <br /> SINK ISEHVICE-(3AF, ETC.I OF VJORK VJILL BE COMPLIE� WITH WHETHER SPECIFIED NEflEIN <br /> OR NOT, THE GfiqNTING OF A PERM1IIT DOES NOT PRESUM[ TO <br /> GNE AUTHOPITv TO VIOLATE Ofl CANCEL THE PROVISIONS OF <br /> AN'I OTHER STATE OR LOCAL L/1VJ REGULl�TING COfJSTRUCTION <br /> SU�TOTAL OR THE PERFORMANCE UF CONSTqUCTION. <br /> PEFMIT 5 <br /> TOTALFEL $ <br /> - x �7�{ <br /> S�NATUREOFCOIdTRACTORORAUTH.AGENT DATE <br /> SIDE YqRD SET�nCK STRF_ET�ET�nCK REAR VqqDSET�ACK PLAY CFIECK NUM�ER <br /> PLAN CHECK FEE <br /> 7��� FEE M � RE�I T NO. <br /> USE ZONE LOT AREA VACANT SITE �Sh� <br /> ❑vE„ ❑No FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GPOVP NO.OF DWELLING �- <br /> UNITS <br /> I <br /> SIZE OF 6LDG. NO.OF STORIES MA%,pC0. LOAC BUILOING 5 �'�{� �(, An <br /> K� W <br /> FIP.EZONE 13ASE�UENT H{iESPRINKLER3 PLUMBING � <br /> RCQJIRED � <br /> CYES ❑NO MECHANICPL � <br /> _ I <br /> SPECIAL CONDITIONS: <br /> -- OTHEF I <br /> — -- I <br /> PENGLiv ScC 303(0l I <br /> " ___ i <br /> TOTAL � <br /> �..M�� � `,.�� <br /> PERMIT VAIIDAT�ON � �- <br /> �� WHEN PRO"OP.' Y VALIDAT[L I:N T'-�ISSPA�F� THIS IS rUUF PERMIT <br /> I <br /> � �ni'�4iip;inCCEPTE�BY� PLnNSC�1ECKEDBY- qPPNJVCOFOpiSSlIF1lC.Eov <br /> i r�• �`• �)• ���T� r`y <br /> I <br /> (� <br />