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rhe fvergreen I <br /> ��T�oF CONSTRUCTION everett <br /> everett PERMIT <br /> ❑iY HAIL 1598885 <br /> [V[XER.WASMINGLON <br /> 9li01 <br /> °E°, °°�°M°°���� gUILDING MECHANICAL PLUMBING <br /> o[v[�ovu[r+r <br /> OWNER M/11L ADDRESS ZIP PHONE <br /> l4CJ:a�T Caa'�r-a°.SCnn 36c'�. Gttt l3�. :;o. ;euLEle 941?,tt �2QL��f a33 <br /> ARCHITECT OR DESIGNER MAIL AD�FESS PHONE LICENSE NO. <br /> $ q� ?2+�.0¢.d['w�4?- ]33r7'� <br /> GENEHALCONTFACTOR MAILAD�RESS PHONE ENO. <br /> MECHANICAL CONTRACTOR MAII ADDHESS PHONE LICENSE NO. <br /> PLVMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLASS OF WORK � <br /> Z <br /> ❑BUILDING �PLUMBING �MECIiANICAL �NEW ❑ADDITION �ITERATION ❑REPAIR ~ <br /> � <br /> VALUATION OF WORK � <br /> i� ❑DEMOLI511 ❑FENCE ❑SIGN ❑SWIMMING POOL W <br /> S _ d <br /> OESCRIBE WORK <br /> � � .�.w� � c��. �, a«� � �� a� �.��a _1247 <br /> PROPOSEO USE MECHANICAL <br /> LEGAL DESCRIPTiON OF PROPERTY ISM01N BELOW OR ATTACH TYPE OF FUEL �OIL �GAns. �LPG. �ELEC. <br /> FOVRCQpIE51 � <br /> LOT �'fl BLOC�oF �'�� N�• TVPE OF EUUIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. $ I <br /> REFRIGERATION UNIT$-M.P. EA. <br /> BOILERS-M.P. EA. I <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> FORCED AIR SVSTE1d5-D.T.U. Od EA. 1 <br /> JOB ADDRE55 WALL HEAiERS-O.T.U. 1d <br /> � ��� UNIT NEATERS-B.T.V. 1A I <br /> EVAPORdTIVECOOLERS <br /> PLUMBING CLOTHESDFVERS I <br /> V ENTILATION FAN � <br /> RANGEHOOD � <br /> NO. TYPEOFFIXTUREORITEM FEE A�RHANOIINGVNiT- C.F.M. <br /> WATERCLOSET(TOILET) 5 WCINEHATOR I <br /> BATHTU9 <br /> LAVATORV(WASM BASINI � <br /> SLIaWER <br /> KITCNEN SINK Bi OISP. SUB TOTA� 5 I <br /> DISHWASHER PEqM1T S <br /> LAUNDRV TRAY TOTALFEE S I <br /> CLOTHES WASHEF _ TMIS PERMIT 0[COMES NULL AN� VOID IF WORK OR CONSTRUC� <br /> WATER HEATER TION AUTHORI2ED IS NOT COMMENCED WITHIN 170 DAVS, OR IF <br /> URINAI. CONSTRUCTION OR WORK IS SVSPENDED OR ABANOONEO FOR A <br /> DRINKING FOUNTAIN PERIOD OF 120 OAVS AT ANY TIME AFTEP WORK IS COMMENCEO. <br /> FLOOR-SINK OR ORAIN 1 HEREBY CERTIFY THAT I MAVE READ AND EXAMINED TNIS AP� <br /> VACUUM BREAKERS PLICATION AND KNnW TME SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF I.AIYS ANO ORDINANCES GOVEPNING THIS TVPE <br /> ROOF DRAINS-RAINIEADEiiS OF WORK WILL BE COMPLIED lYlTli WHEiHEFl SPECIFIEO MEREIN <br /> SINK(SERVICE-BAF,ETC.1 OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AU�HORITV TO VIOLATE OR CANCEL THE PROVIS�ONS OF <br /> ANV OTNER STATE OR IOCAL LAW FEGULATING CONSTRUCTION <br /> OR THE PEP.FORMANCE OF CONSTRUGTION. <br /> SUOTOTAL <br /> PERMIT 5 <br /> TOTAL FEE S ��1�[ <br /> x ewarr� <br /> SIGNATUREOFCONTIiACTORORAUTH.AGENT �ATE <br /> SIOE VARD SETDACK STPEET SET6ACK REAR YARO SETBACK P�AN CHECK NVMBER PLAN CHECK FEE <br /> F[E RECE�PT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑VES ❑NO FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANGV GROUP NO.OF DWELLING <br /> UNITS �M <br /> 512E OF OLOG. NO.CF STORIES MAX.OCC. LOAD BUILOING $ S�+'�7� 7 jw <br /> PLVMBING � <br /> FIREZONE 6ASE�tENT FIRESPRINKLERS <br /> RL�UIREO � <br /> ❑VES ❑NO MECHANICAL 1 <br /> L SPECIALCONDITIONS: OTHER � <br /> I <br /> PENELTV SEC.3071a) � <br /> TOTAL 5 1 � <br /> PERMIT VALI�ATION <br /> WHEN PROPERLY VALIOATED IIN THIS SPACE)THIS IS YOUR PERMIT <br /> PMIICATION�ttLPT[DBY: VLN�SI'NEIXEODV�. HVVROV[}O�FOPISSUANC[BY. <br /> � :'i� <br /> .Z <br /> r <br />