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Nre fvergreen <br /> CITYOF CONSTRUCTION everett <br /> everett PERMIT <br /> CILY IIAII 1598l85 <br /> [VfNEii.WA$NINGiON <br /> 9Ei01 <br /> o[rr.arconvauwnv BUILDING MECHANICAL PLUMBING <br /> o[v[tcrw[xr <br /> OWNER MAIIADORE55 21P PHONE �q <br /> ;1, .� C.3������ 6��1 f <br /> ARGHITECT OF L)ESIGNER A1AI�A��RESS PHONE LICENSE NO. <br /> GENERALCONTRACTOR MAILADDRE55 PHONE LICENSENO. <br /> .°}f�.n <br /> MEGHANICALCONTRACTOR MAILAODRESS PHONE LICENSENO. <br /> PLUMflINGCONTRACTOR MAILAODRESS PHONE LICtNSENO. � <br /> W <br /> m <br /> '::.'I`!?' ' AiR!' `�J.'3� f <br /> PEFMIT C�ASSOF WORK � <br /> Z <br /> QBUII.OING �]PLUMBING �MECHANICAL F <br /> ❑NEW ❑ADDITION �ALTEFATION ❑REPAIR � <br /> VALUAT�ON OF WORK � <br /> ❑DEMOLISN ❑FENCE ❑SIGN ❑SWIMMING POOL W <br /> s a <br /> DESCRIBE WORK A�O� <br /> �t�•;•?.7�i ��Li 1 � �� �i 0 <br /> PROPOSED USE MECHANICAL <br /> TVPEOFFUEL �OIL �GAS. �LPG. �ELEC. <br /> �EGAI DESCRIPTION OF PNOPERTV ISHOW BELOW OR ATTACH <br /> FOUF COPIESI <br /> NO. TVPE OF EOUIPMENT FEE <br /> LOT 9LOCK—OF AIR CONO.UNITS-H.P. EA. 5 � <br /> REFRIGERATION UNITS-H.P. EA. <br /> �OILERS-N.P. EA. � <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> FORCEO AIR SVSTEMS-U.T.U. M EA. I <br /> JOB ADDRESS 'q �y WALL tiEATERS-B.T.U. M <br /> y�� IQ'��1'�1 UNIT HEATERS-B.T.V. M I <br /> EVAPORATIVECOOLERS <br /> PLU!ABING CLOTHESDRVEPS � <br /> VENTILATIONFAN <br /> RANGE HO00 � <br /> NO. TVPE OF FI%TURE OR ITEM FEE Alft HANOLING VNIT- C.F.M. <br /> WATERCI.OSETITOILET) g INCINERATOR � <br /> BATN'fU8 <br /> IAVATORY(WASH BASINI � <br /> SHOWER <br /> KITGHEN SINK&DISP. SU9 TOTAL 5 <br /> OISHWASHEfi PERM�T 5 <br /> LAUNDiiY TRAV TOTAL FEE 5 <br /> CLOTHES WASHER TMIS PEflMIT �ECOMES NULI AND VOIU IF WORK OR CONSTRUC- <br /> WATER MEATER TION AUTHOFI2ED IS NOT COMMENCEO WITHIN 770 OAVS,OR IF <br /> UHINAL CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONED FOR A <br /> ORINKING FOUNTAIN PENIOD OF 120 DAYS AT ANV TIME AFTEF WORK IS COMMENCED. <br /> FLOOH-�SINK OR DRAIN 1 HEFE�V CEftTIFV THAT 1 HAVE F7EAD AND EXAMINED THIS AP- <br /> VACUUM BHEAKERS PLICATION AND KNOW TNE SAME TO BE�RUE AND CORRECT. ALL <br /> PHOVISIONS OF LAWS AND OHDINANCES GOVERNING THIS TVPE <br /> ROOF DRAINS-RAINLEADEHS OF WOFK WILL BE COM°LIED K'ITN WHETHER SPECIFIEO HEREIN <br /> SINK (SERVICE-BAR,ETC.) OR NOT, THE GRANTING OF A PERMIT COES NOT PRESUME TO <br /> GIVE AViHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAW REGULATING CONSTPUCTION <br /> OR THE PERFORMANCE OF CONSTflUCTION. <br /> SUBTOTAL <br /> PERMIT 5 <br /> TOTALFEE $ <br /> X � <br /> SIGNATUfiEOFCONTRFCTORORAUTH.AGENT �AT <br /> SIDE VARDSETOACK STREET SET�ACK REAR VAfiDSET9AC PLAN CHECK NUMBER PLAIV CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑vEs ❑No FEES VALUATION FEE <br /> TVPE OF GONST. OCI:UPANCV GROUP UNIT�S DWELLING � <br /> SIZE OF (3LOG. NO.OF STORIES MA%.OCC. LOAD E�UILOING 5 �yy �,q� <br /> PLUMBING ��y�/ <br /> FIFEZONE 9ASEMENT qfOUIREDKLERS <br /> ❑YES ❑NO MECHAfJICAL �+�� <br /> ✓I <br /> SPECIAL CONDITIONS: OTHER � <br /> PENELTV SEC.30�1a1 � <br /> TOTAL �I(� <br /> PERMIT VALIDATION <br /> WHEN PROPERLV VAIIDATED fIN TI1i5 SPACE)Th1151S VOUR PERMIT <br /> ppP�ICRTIONPCCEPT[pBY� PLAN501EC��"OBY' �PPf10VCUiOFI55U�NCCBY. <br /> � Q� <br /> Q <br />