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Uie Evergreen <br /> CITV OF CONSTRUCTION evecett <br /> everett PERMIT � <br /> UiV NFII ns�eus <br /> CVEPCLI,IY�SNINGiON <br /> 9t101 <br /> o[rcarcaraMururv BUILDING MECHANICAL PLUMBING <br /> o�v[iorMcxr <br /> OWNER MAIL AO�PE55 21P PHONE <br /> 'm R�S�'T ��� <br /> ARCMITECT OR DESIGNER MAIL ADDRE55 PHONE LICENSE NO. <br /> GENERALCONTRACTOR MAILADORESS PHON� Y _ C S' �J�A�� <br /> �� �it� Cli� LC�.� . Y�+/ f� <br /> MECHANICAI CONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. <br /> PLUMBING CONTRACTOR MAIL ADOFESS PHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLASSOf WOPK � <br /> Z <br /> �BUILDING ❑PLUMBING �MECliANICAL �NLW ❑ADDITION ❑ALTERATION �REPAIR ~ <br /> VALUATION O WO � <br /> S � ❑DEAIOLISH ❑FENCE ❑SIGN ❑SWIMMING POO� a <br /> DESCRIBE WORN �ASw <br /> �'�'� Y V <br /> PROPOSED USE MECHANICAL <br /> LEGALOESCRIPTIONOI PROPERTV ISNOW DELOW Ofl ATTACH TYPE OF FUEL �OIL �GAns. �LPG. �ELEC. <br /> FOUR COPIES) <br /> LOT OLOCK__oF NO. TVPEOFEQUIPMENT FEE <br /> AIR CONO.UNITS-H.P. EA. S I <br /> REFRIGERATION UNITS-H.P. EA. <br /> BOILEflS-H.P. EA. I <br /> GAS FIRED A.C. UNITS-TONNAGE EA. <br /> FORCEO AIR SYSTEMS-�.T.U. M EA. I <br /> J09 ADDRE55 ��y� WFLL HEATERS-B.T.U. M <br /> y�i7 � UNIT HEATEFS-6.T.U. M I <br /> EVAPOFATIVECOOLERS <br /> PLUMBING CLOTHESDRVERS I <br /> VENTILATION FAN <br /> RANGEHOOD I <br /> NO. T'PE OF FIXTURE OR ITEM FEE �+�R HANDLING UNIT- C.F.M. <br /> WATERCLOSETITOIIET) g �NCINERATOR I <br /> BATHTUB <br /> LAVATOHV�WASHBq51N) � <br /> SHOWER <br /> KITCMEN SINK b UISP. I SUB TOTAL 5 � <br /> DISHWASHER PERMIT 5 <br /> IAUNORY TRAV TOTALFEE 3 <br /> 1 <br /> CLOTHES WASHER THIS PERMIT UECOMES NULI AND VOIO IF WORK OR CONSTRUC� <br /> WATER NEATER TION AVTIIORI2E� IS NOT COMMENCEO WITHIN 1�0 bAVS, OR IF <br /> URINAL CONSTRVCTION OR WORK I$ SUSPEN�ED OR ABANDONEO FOR A <br /> DRINKING FOUNTAIN PEfi�OD OF 120 DAVS AT ANV T�ME AFTER WORK IS COMMENCED. <br /> FLOOR-SINK GR ORAIN I HER[BY CERTIF'I THAT I NAVE READ AND EXAMINED THIS AP� <br /> VACUUM BREAKERS FIICATION ANU KNOW THE SAMF TO BE TRUE AND C09RECT.A�L <br /> qOOF DRAINS-FlAINIEADERS PROVISIONS OF LAWS AND OFOINANCES GOVEpNING THIS TYPE <br /> OF WOflK \NILL �E COMPLIED WITH WMETMER SPECIFIED HENEIN <br /> SINK (St�VICE-BAR, ETC.) Ofl NOT, TNE GfiANTING OF A PERMIT DOES NOT PFcSUME TO <br /> GIVE AUTHORITV TO VIOLFTE OR CANCEL TNE PPOVISIONS OF <br /> ANY OTHEP STATE OR LOCAL I.AIY REGULATING CONSTRUCTION <br /> OF TME PERFORMANCE OF CONSTRUCTION. <br /> SUB TOTAL <br /> PERMIT 5 <br /> TOTALFEE S �/y�� <br /> x ��r��Y <br /> SIGNATVREDFCONTRl�CTOFORAUTIi.AGENT DATE <br /> SIDEVARDSETOACK STRCETSETBAfK REqRVARDSET6AC PLANCHECK NUM�ER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USEZONE LOTAFEA VACANTSITE <br /> ❑vEs ❑NO FEES VALUATION FEE <br /> TYPE OF CONSi. OCCUPANCY GROUP UOi05 OWELLING ' <br /> SIZE OF OLDG. NO.OF:TORIES 1+:A%.00C. LOAO DUILDING 5 <br /> PLUMDING � <br /> FIREZONE �1ASEMENT FIRESPFINKLERS <br /> qE(]UIRED <br /> ❑`!ES ❑NO MECHANICAL I <br /> SPECIAL CONDITIONS: pTHER � <br /> _ I <br /> PENELTV SEC.307101 I <br /> TOTAL � � <br /> PERMIT VALIDATION <br /> WI1EN PqOPERLY VALIDATED�IN TIi15 SPACE)THI515 VOUR PEHMIT <br /> �n'L��.�iiONAGCEPifDBY�. PLFNSCNECKED�V'. AVPqO'�DFOwIS;U�HCCBY. <br /> � v� <br /> Q <br />