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�r,: Evergreen - <br /> ��,�aF CONSTRUCTIOtV everett I <br /> everett PE'2MIT <br /> LItYNAIt }yu�g85 <br /> CVfX111.W45NINGIDY <br /> 9�Ni <br /> °`°` °"°'""°""° BUILDING MECHANICAL PLUMBING <br /> oevEioi�.ien.. <br /> OWNER MAILIIDDRESS ZIP PHONE <br /> C.e,. :�mr�a :n 3�?�3 <br /> ARCMITECTOROESIGNER MAILADDRE55 PHONE LICENSEND. <br /> ��� <br /> GENERALCONTRACTOR MAILADORESS ��y PH.�O�NE I.�CEN5EN0. <br /> YA � QS�Q U�' �`JY�7N <br /> MECMANICAI CONTRACTOR MAIL ADDRESS PNONE LICENSE NO. <br /> PLUMPIVGCONTflACTOR MAILAUDRESS PHONE �ICENS� NO. W <br /> m <br /> PEFMIT C�ASS OF WqRK � <br /> _ � Z <br /> ❑BUILDING �PLUMBING �MECHANICAL F. <br /> ❑NEV� ❑AOD�TIOtJ �'DALTERATION ❑REPAIH � <br /> VALUALION OF WORK <br /> S�1lr� M ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL W <br /> 77�N�l a <br /> OESCRIBE WORK . <br /> sta." lltau 19os�'aemR to t'I.nL 1ore1 2326 <br /> PROPOSED USE <br /> MECHANICAL <br /> TYPEOFFUEI. �OIL CNAT. �LPG. �ELEC. <br /> LEGAL DESCRIPTION OF PROPERTY �SNOW BELOW Ofi ATTACII GAS <br /> FOU COP S) <br /> �o a�ocK�UF ��C N�• TVPE OF EUUI�MENT FEE <br /> AIR COND. UNITS-N.P. EF. $ I <br /> REFRIGERATION UNITS-f1.P. EA. <br /> DOILERS-H.P. EA. � <br /> � GAS PIRED A.0 UNITS-TONNAGE EA. <br /> FORCEO AIR SVSTEMS-B.T.U. M EA. I <br /> JOB AOORE55 WALL HEATERS-B.T.U. M <br /> i = �tt UNIT MEATERS-�.T.U. M I <br /> EVAPORATIVECOOLEFS <br /> PLUMBING CLOTHES ONVERS <br /> _ I <br /> VENTILATION FAN <br /> RANGEHOOD � <br /> NO. TYIE OF FIXTURE OR ITEM FEE �11P HANDLING UNIT- QF.M. <br /> WATERCICSETITOILETI g �NCINERATOFi � <br /> BATNTUB <br /> LqVATORY�WASH BASINI � <br /> SHOWEfi <br /> KITCHEN SINK&DISP. SUB TOTAL 5 <br /> I <br /> �I]HWASHER PERMIT 5 <br /> LAUNORV TRAV �' <br /> CLOTHES WASHER • TOTALFEE 5 � <br /> THIS PEFMIT BEI;OMES NULL ANO VOID IF WOP,K OR CONSTRUC- <br /> WATER HEATER TION AUTHORI2EO IS NOT COMMENCED WITHIN 120 DAVS, OR IF <br /> UqINAL � CONSTRUCTION OR WORK IS SUSPE4DE0 OR ABANDONED FOR A <br /> DRINKING FOUNTAIN PEHIOD OF 120 OAVS AT ANV TIME AFTER WORK IS COMMENCED. <br /> FLOOR-SINK OR DRAIN I HEHC6Y CERTIFY TN�1T I NAVE REAO AND E%AMINED THIS AP- <br /> VACUU BREAKERS PLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT. ALL <br /> ROOF DRAINS-RAINLEF�FRS PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WOHK WILL BE COAIPLIED N'ITH WHETHER SPECIFIED MEREIN <br /> SINK ISERVICE-BAR,ETC.) Ofl NOT, TME GRANTING OF A PERM1IIT DOES NOT PRESVME 7p <br /> GIVE AUTMORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAW REGULATINGCONSTFUCTION <br /> _ OR,THE PERFORMANCE Of CONSTfiVCTION. <br /> SUB TOTAL //�� <br /> PERMIT $ )��'_"J\'1 . ) Y '�✓ � �If <br /> TOTALFEE $ <br /> ;Cv <br /> SIGNATUREOFCONTRACTOROftAUTli.AGEhT �ATE <br /> SIOE YARD SETBACK STREET SETHACK REAR YARDSET�AC PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AflEA VACANT SITE <br /> ❑vEs ❑No FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF OWELLING <br /> UNIT$ � <br /> SIZE OF BLDG. NO.OF STORIES MAX.00C. LOAD DUIIDING 5 � � �� <br /> FIPE20NE BASEMENT FIRESPftINKLEFS PLUMOING ; <br /> Rf�UIf7ED <br /> ❑YES ❑NO MEC/IANICAL � <br /> SPECIAL CO4DITIONS: OTHEF � <br /> _ I <br /> ---- PENELTY SEC.3�31a1 I <br /> TOTAL � �� <br /> PERMIT VALIDATION <br /> WHEN PROPERLV VAI_IDATED IIN THIS SPACEI l'HI515 VOUR^?R'.11T <br /> PPPLICATIONnCCCPIEUBV' PlANSCNECKCO�Y�. APPpOV[�FO(1155U�NCCBV. <br /> � � � <br /> 4 <br />