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rhe fvergreen <br /> ��TYo� CONSTRUCTION everett <br /> eve rett PERMIT <br /> UtV MAII 1]98&95 <br /> EVI N[il,W45NiNG�ON <br /> 9E101 <br /> °'" °o��<<o;ME;;, BUILDING MECHANICAL PLUMBING <br /> OWNER �fA1L ADDi1`.SS ZIP PHONE <br /> T � <br /> AR 1- D SI ER /11LADOfiE55 PMONE LICENSENO. <br /> GENERA�CONTRACTOR MAIL ADDRESS PNONE LICENSE NO. <br /> MECHAN�CALCONTRACTOR MAILAD�RESS PHONE LICENSENO. <br /> I1S1F3 .�i TLBP 4 6'r+,.3'.T sb 1 � 1� 1""C'.�Li"� �0 <br /> PLUMBING CONTRACTOR MAIL AD�PESS PHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLASS OF WORK � <br /> Z <br /> ❑BUILDING ❑PLUMBING �MECHANICAL F <br /> �]NEW ❑ADDITION ❑ALTERATION ❑REPAIR � <br /> VALUATION OF WORK � <br /> 5 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMh11NG POOL a <br /> OESCRIBE WORK <br /> osi <br /> PROPOSED VSE <br /> h1ECHANICAL <br /> L[GAL DESCRIPTION OF PROPERTV�SHOW DELOW OR ATTICH TYPE OF FUEL I�OIL �Gns. �LPG. �ELEC. <br /> FOUR COPIE51 <br /> LOT BLOCK_oF NO. TYPEOFE�UIPMENT FEE <br /> AIR CON�. UNITS-N.P. EA. $ � <br /> REFRIGERATION UNITS-H.P. EA. <br /> -- BOILERS-H.P. EA. � <br /> GAS FIRED A.C. UNITS-TONNAGE EA. � <br /> _ FOPCEO AIR SYSTEMS-H.T.U. M EA. � <br /> JOB ADDRESS � Y� WALI HEATERS-D.T.U. M <br /> ��ii� UNIT HEATERS-B.T.U. M <br /> PLUMBING EVAPORATIVECOOLERS <br /> C�OTMESDFVERS � <br /> VENTILATION FAN <br /> FANGEHOOD I <br /> NO. TVPE OF FIXTURE OH ITEM FEE A�R NANDI.ING UNIT- C.F.M. <br /> WATERCLOSET�TOILET) g INCINERATOR � <br /> BATHTUB <br /> LAVATORVIWASH BASINI � <br /> SHOWER <br /> KITCHEN SINK& OISP. SU�TOTAL S <br /> � OISNWASHER PERMIT $ <br /> LAUNDRV TRFV <br /> TOTAL FEE 5 <br /> CLOTHES WASHEF THIS PERMIT OECOMES NULL ANO VOID IF WORK OR CONSTRUG <br /> WATEP NEATER TION AV'HORI2ED IS NOT COMAIENCED WITHIN 170 DAVS,OR IF <br /> UflINAL CONSTFUGTION OH \YORK IS SUSPENnEO OR A�ANDONED FOR A <br /> DRINKING FOUNTAIN PERIOD OF 120 DAVS AT ANV TIME AFTER WORK IS COMMENCED. <br /> FLOOR-SINK OR DFAIN I NEREOV CERTIFY THAT I HAVE REAO AND E%AMINEO THIS AP� <br /> VACUUM 6REAKEAS PLICATION AND KNOW THE SAME TO 6[TRUE AND CORqECT.ALL <br /> ROOF DPAINS-RqINLEADEflS PROVISIONS OF LAWS AND ORDINANC[5 GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITIi N'NETHER SPECIFIEO NEREIN <br /> SINK(SERVICE-OAR, ETC.1 —� OP NOT, THE GRANTING OF A PtqMIT OOES NOT PIiESUME TO <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTIIER STATE OR LOCAL LAW R[GVLFTiNG CONSTRUCTION <br /> OR THE PEPFORMANCE OF CONSTRVCTION, <br /> SUeTOTAL <br /> PERMIT 5 <br /> TOTAL FEE 5 <br /> x <br /> SIGNATVFlEOFCONTFACTOFORAUTH.AGENT OATE <br /> SIDE VAR�SETBl�CK STFEET SETDACK FEAR VAR�SET�AC P�AN CMECK NUAtOER PLAN CHECK FEE <br /> FEE qECE1PT NO. <br /> USEZONE LOTAREA VACANTSITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYP[ OF CONST. OCCUPqNCV GROUP NO.OF DWELLING <br /> UNITS � <br /> Si<t Of CLOG. NO. OF STORIES MA%.00C. LOAO BUILDING 5 � <br /> I <br /> FIRE20NE BASEMENT FIIiESPRINKLERS PLUMBING i <br /> RE�UIRED � <br /> ❑VES ❑NO MECHANICAL 1• <br /> 4� <br /> SPECIAL CONDITIONS: OTHER � <br /> I <br /> PENELTY SEC. 7�31a1 I <br /> TOTAL � <br /> PERMIT V�LIDATION <br /> — WNEN PPOYEIiLV VALIOATEO;IN THISSFACE)Tr11S IS VOUR PERMIT <br /> �PPLICAT�ONAttCPTC08V� PLANSCNKNCOBY: APPROVCDfOPI55UANCCBY. I <br /> � <br />