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the Evergreen <br /> CITYOF CONS�RUCTION everett <br /> eve rett PERMIT <br /> CIiY Nnll 1598t85 <br /> NENEiI.WASXiNG10N <br /> 9[I01 <br /> ocri.arcouMuxirv BUILDING MECHANICAL PLUMBING <br /> ocv[�orM[xt <br /> OWNER MAILAODRE55 21P NMONE <br /> Seattlo First tiaCioaal Laa:: ('!aiia,er) 985-7? <br /> ARCHITECT OR DESIGNER MAIL AODRE55 PHONE LICENSE NO. <br /> GENERAL CONTRACTOP MAIL ADDRESS PH LI 5 O. <br /> Lehsnr ltoofinq I51� Sttt:� :.v'e. 33S-v���3 223-�2-�l.�= t. _A -C21GI,Y <br /> MECHANICAL GONTRACTOR MAIL A�URESS PHONE LICENSE NO. <br /> PLVMBING CONTRACTOR MAIL AD�flE55 PHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLl1S5 OF WORK � <br /> Z <br /> ❑BUIIOING �PLUMBING ❑MECNANICAL �( F <br /> UNEW ❑ADDITION ❑ALTERATION (:1REPAIR � <br /> VAlUAT10N OF WORK � <br /> '��,�� '�y ❑OEMOLI511 ❑FENCE ❑SIGN ❑SWIMMING FOOL W <br /> s °� <br /> DESCRIBE WOPK /���� <br /> patch wook - r=oa3r robf L <br /> PROPOSEO VSE MECHANICAL <br /> TVPEOFFUEL �OIL �NAT. �LPG. �ELEC. <br /> LEGAL�ESCRIPTIDN OF PROPERTV (SNOW UELOW OR ATTACM GAS <br /> FOUR COPIE51 <br /> NO. TVPE OF EQUIPMENT FEE <br /> LOT BLOCK_OF <br /> AIR COND. UNITS-H.P. EA. S � <br /> qEfRIGEFATION UNITS-H.P. EA. <br /> _ OOILERS-H.P. EA.� I <br /> GAS FIPED A.C.UNITS-TONNAGE EA. <br /> FORCED AIR SVSTEMS-B.T.U. M EA. I <br /> JOB AOORES�j WALL NElaTERS-B.T.U. M <br /> Z�CS1 F:@�IS.�C AWZISu@ UNIT MEATERS-B.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTHESDRVERS I <br /> VENTILATION FAN <br /> RANGEHOOD I <br /> NO. TVPE OF FIXTURE OR ITEM FEE AIR HANDLING VNIT- C.F.M. <br /> WATER CLOSET(TOILETI 5 INCINERATOR 1 <br /> BATHTUB <br /> LAVATORYIWASHBASIN) � <br /> SHOWER <br /> KITCHEN SINK& DISP. SUB TOTAL 5 I <br /> DISHWASHER PERMIT $ <br /> LAUNDRY TFAV TOTAL FEE 5 I <br /> CLOTMES WASHER TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC� <br /> WATER NEATER TION AVTHORI2ED IS NOT COMMF.NCED WITHIN 120 DAYS, OR IF <br /> URINA� CDNSTRUCTION OR WORK IS SUSPENOED OR ABANDONED FOR A <br /> DPINKING FOUNTAIN PERIOD OF 120 DAYS AT ANV TIME AFTER WORK ISCOMMENCED. <br /> FLOOR-SINK OR DRAIN I HEREBY CERTIFY THAT I NAVE READ FND E%AMINED THIS AP- <br /> VAGVUM BREAKERS PLICATION AND KNOW THE SAME TO BE TRUE AND GORRECT. ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVEflNING THI$ TVPE <br /> ROOF DRAINS-qAINLEADERS OF WOFK WILL BE COh1PLIED W�TN WHETHEfl SPECIFIED HEREIN <br /> SINK(SERVICE-BAH.ETC.1 OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITY TO VIOLAiE OR CANCEI THE PROVIS�ONS OF <br /> ANV OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTRUCTION. <br /> SUB TOTAL <br /> PERMIT $ �/2J/'�'' <br /> TOTALFEE 5 <br /> X <br /> SIGNATUPEOFCONTRACTORORAVTH.AGENT DATE <br /> SIDEVARDSETBACK STREETSETUACK FEARYAqDSET�AC �LANCHECKNUMeER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USEZONE LOTAREA VALANTSITE <br /> ❑YES ❑No FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP VNiOs DWELLING � <br /> SIZE OF BLDG. NO. OF STORIES MAX.OCC. LOAD BUILDING 5 �����Q � � �� <br /> PLUMBING � <br /> FIRE20NE BASEMENT qEpVIPEDKLERS <br /> I <br /> ❑YES ❑NO MECHANICAL I <br /> SPECIAL CONDITIONS: OTNER � <br /> I <br /> PENELTY SEC.7031a) � <br /> �� <br /> TOTAL I <br /> PERMIT VALIDATION <br /> WHEN PROPEftLY VALIDATEO(IN THIS SPACEI THIS I$VOUfl PEfiM1T <br /> APCLICAIIONACCEPTEDBY: �L�NSCHELN[pOY: 4PPAOVEDfOPI.'WRNC[BY�. <br /> L.}J. <br /> A <br /> . • <br />