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� !he fverqn�en I <br /> � ��r, �F CONSTRUGTION everett <br /> everett PERMIT <br /> � �„r,.:�� ,,,.:.s <br /> CVCd[li C:LSHI4GLOry <br /> 931�1 <br /> I °E�� °F�°���.,��°� BUILDING MECHANICAL PLUMBING <br /> otve.orM[ur <br /> OWNEA MAILADDRE55 ZIP �'HONE <br /> 9T[F.� L. � �.a <br /> ARCHITECTORDESIGNbR YIAILADDRE55 PNONE LICENSENO. <br /> r,;:,••�7 <br /> GENERALCONTRACTOR MAILADDflE55 PHONE �I�CEN5EN0. <br /> t_��ii Fu '_��: �.i„y � i4V.�j , �J1 '. .li�l i'•.-: <br /> Mf.CHANICALCONTRACTOR MAILADDPESS PMONE LICENSENO. <br /> � <br /> PLUM�ING CONTFACTOR MAIL ADDFESS PHOkL LICENSE NO. W � <br /> m <br /> � <br /> PERMIT CLASS OF WORK � <br /> z <br /> �9UIlDING � PLUMpING �MECHANICAL 7� ~ <br /> pNEW ❑f�DO:TION r�ALTEflATION ❑R[PAiR � <br /> . VALUATIOM OF WORK � <br /> ❑DEMOLISH ❑FENCE ❑siGN ❑SWIMMING POOL W <br /> 5 �D`YX`..� — _a <br /> DESCRIBE WORK � �� ��O <br /> C.e:"'Str'� '• ;�".O."°�'�+ �:'Ih"!'�'I � �:�'i%`C 9 <br /> Naoroseo use MECHANICAL <br /> TVPEOFfUEL �CiL �GnS. �LPG. �ELEC. <br /> L'cGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTAGH <br /> FOUfl o I 5 <br /> ;� ���j y� S�(jE NO. TYPF.OP E�UIPMEN7 FEE <br /> LOT � OCK_OF qIRCOND. UNI"5-H.P. EA. 5 � <br /> fiBFRIGEFiATION UNITS-H.P. E4. � <br /> DOILERf-H.P. [A. I <br /> GPS FIFSED AG UNITS-T(`NNAiE E�. —r- <br /> _L.— <br /> FORCED Alq SYSTEMS-B.T.U. M EA. I <br /> JOB ADDRE55 WALL HEl1TER5-B.T.U. M �_ <br /> I `"`��3 L�!�F�� _ UNIT HEATERS-R.T.U. M __ � <br /> I � — EVAPOFATIVECOOLERS _1 <br /> PLUMBING CLOTHESORVEHS � <br /> VENTILATION FAN T <br /> � RANGE 1100D _ � I <br /> I NO. TVPE OF FIXTURE OR ITEM FEE — ��A HANDLING UNIT- QF.M. � I <br /> INCINEHATOR I <br /> WATER CLOSET �TOILET) 5 - T— <br /> 6ATHTU6 ---+� <br /> LAVATOFYIWASHBASINI -- ' I <br /> _T— <br /> SHOWER -�—'-- <br /> KITCHEN SINK& DISP. � SU6 TOTAL 5 1 <br /> OISHWASHER PERMIT 5 <br /> iLAUNDHV TRAV TOTALFEE 5 I _ <br /> . CLOTHESVJASHER THIS PEFMIT BECOMES NULL ANO VOID IF WOflK OR CONSTPUG <br /> 'I - WATER HBATEF TION AUTHORIZED IS NOT COMMENCEO WITHIN 120 nAYS, OR IF I <br /> URINAL CONSTRUCTICN OR WORK IS SUSPENOE� OR A�ANOONED FOR A <br /> DiiINKING FOUNTAIN PEflIOD OF 120 DAYS AT ANV TIME APTER WOFK IS COMMENCED. <br /> FLOOR-SINK OR DRAIN —~— � HEFEBV CERTIFY THAT I HAVE REAO ANO EXANiIJED iH15 AP- i <br /> PIICATION AND KNOW THE SAME TO�E TRUE ANO CORRECT. ALL <br /> VACUUM 6REAK[RS pqpVISIONS OF LAWS AND OROINANCES GOVERNING THiS TYPE <br /> ROOf DRAINS-RAINLEA�ERS Of- WOPK WILL BE COMPLIED WITH WHETHER SP[CIFIE� HEflEIN <br /> I SINK (SEFVICE-BAR, ETC.) OF NOT, THE GRANTING OF A PERMIT DOES NOi PRESUM1IE TO <br /> GNE AUTI'ORITV TO VIOLATE Ofi CANCEL THE PflOVI510N5 OF <br /> I _ AIJV OTHeR STATE OR LOCAL LAW RLGULATING CONSTHUCTION <br /> I �_ OR THE PERFJRMnNCE OF CONSTRUGTION. <br /> SU�TOTAL <br /> PERMIT 5—� <br /> TOTAIFEE 5 <br /> �I SIGNATUREOFCONTRACTOFORAUTH.AGENT DAT[ <br /> II <br /> SIOEY�CJiDSBTE3ACK STREETSETDACK RLARIP�iO55T�ACKPLANCHECKNUM�ER PIANCHECKFEE <br /> �I U' `Y?,�(y' FEE�'� R�C�I➢�NO. <br /> f <br /> USE20NE LOTAREA VACANTSITEx <br /> ❑vEs L7No FEES VALUATION FEE <br /> I TYP[ OF CONST. OCGUPANCV GROUP VNiOs DWELLING � <br /> qa%t .T �. � — <br /> y � . nt� a� <br /> i SIf�QEULOG. NO. OF�TORIES MAx.00C. LOA� BUILDING 5 1�} ,%��x� _ G�..1 � � <br /> 9[l'R{4, �-- <br /> P�UMBING � I <br /> ' I��FE201� BAS[M116N1' fIViESPFiINKLEf�S _.— � <br /> RC(]UIREO $ � <br /> '� ❑YES UNO MECHAHICAL I — I <br /> . �rL�::iVOITIONS: GTHER I <br /> _ I <br /> —' ---�— <br /> _ _ PENELTY SEC. 9031n1 � <br /> TOTAL ,�„�1 fXS I <br /> i <br /> I -- PERMIT VALIDATION I <br /> WHEN PqOPERLY VALI�ATED(IN THISSPAC[1 T�1151:VOl�3 PCHPdIT <br /> APVIICAi10'JACC(P1F�9Y�. PLPNSGNFC����Y�. APPNOVEOIOPIGSU�GLCIIV. <br /> W: <br /> /., <br /> . � <br />