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, <br /> rhe Evergreen <br /> CITV OF CONS i RUCTION everett <br /> everett PERMIT <br /> [iLV NFIL ]59PF85 <br /> EV[Rfii,NASIIIHCr10N <br /> 991�� <br /> °�°, °°�°MM°�°� BUILDING MECHANICAL PLUMBING <br /> o�vuorucxi <br /> OWNER MAIL AD�fl[SS ZIP PIiONE <br /> i i 1t l� ! <br /> ARCHITECT OR DESIGNEF MAIL ADORESS PHONE L�GENSE NO. <br /> ��� <br /> GENERAL CONTPACTOF MAIL ADDRESS PHONE L�CENSE NO. <br /> �rare�t :.3� ca <br /> MECHANICAL CONTRACTOR MAIL ADOHE55 PHONE LICENSE NO. <br /> PlUM81NG CONTRl�CTOR MAIL ADDRE55 PMONE LICENSE NO. � <br /> W <br /> m <br /> PEfiM1T CLASS OF WORK � <br /> Z Z <br /> []BUILDING ❑ PLUMDING ❑MECIiANICAL F' <br /> ❑NEW L�AODITION ❑ALTERATION ❑REPAIR � <br /> VALUATION OF WORK � <br /> $ ' ❑DEMOLISM ❑F[NCE �SIGN ❑SWIMMING POOL a . <br /> DESCRIBE WOAK /���� <br /> �� � � <br /> PROPOSED U5E MECHANICAL <br /> LEGALOESCRIPI'IONOF PROPEfiTV ISHOW�ELOW OR ATTACN TVPE OF FUEL �OIL �GAAS. �I.PG. �EIEC. <br /> FOl'R COPIE51 <br /> NO. TVPE OF EQUIPMENT FEE <br /> LOT OLOCK—OF AIR COND, UNITS-H.R EA. 5 I <br /> REFFIGERATION UNITS-M.P. EA. <br /> f301LEFS-�H.P. GA. 1 <br /> GAS FIRE�A.C. UNITS-TONNAGE EA. <br /> FORCED AIF$VSTEM$-�.T.U. M EA. I . <br /> JOB AODRE55 WnLL MEATERS-B.T.U. M <br /> � ��1: �� UNIT HEATERS-B.T.U. M � I <br /> EVAPORATIVECOOLERS <br /> PLUMBING CLOTH[5 Ofi V ERS I <br /> VENTILATIONFAN , <br /> Rl�NGE HOOD I <br /> NO. NPEOFFI%TUREORITEM FEE AIFHANOLINGUNIT- �.F.M. <br /> WATERCLOSETITOILET) g �NCINERATOR I <br /> BATHTIIe <br /> LAVATOPY IWASH BASIN) � <br /> SNOWER <br /> KITCHEN SINK& �ISP. SUB TOT/1L 5 � <br /> DISHWASNER PERMIT 5 <br /> LAUN�FV TRAV TOTALFEE 5 � <br /> CLOTHES WASHER . THIS PEftM1T �ECOMES NULL AND VOIO IF WORK OR CONS.RVG <br /> WATEF HEATER TION AUTNORI2ED IS NOT COMAIENCED WITHIN 120 DAVS, OR IF � <br /> VRINAL CONSTRVCTION OR WORK IS SVSPENDEO OR hBANOONED FOR A <br /> DRINKING FOUNTAIN PERI00 OP 120 DAVS AT ANV TIME AFTEf WORK IS COMMENCED. <br /> FLOOR-SINK OF�RAIN I HERE�V CERTIFY TH/1i I HAVE FEAD AND LrAMWED THIS AP� <br /> VACUUM BflEAKERS PLICATION AND KNOW THE SAME TO [1[TflUE AND CORRECT. ALL <br /> ROOF DRAINS-RAINLEADERS PROVISIONS OF LAWS AND OP�INANCES GOVEHNING TNIS TYPE <br /> Of- WORK WILL BE COMPIIED WITH WMETHEfi SPEdF1ED NEREIN <br /> SINK (SERVICE-UAR, ETC.) OR NOT, THE GRANTING OF A PERht1T OOES NOT PRESUME TO <br /> GIVE AUiHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE Ofl LOCAL LALV REGULPTING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTfiUCT10N. <br /> SUA TOTAL <br /> PERMIT 5 <br /> TOTAL FEE $ 2�1�� <br /> X <br /> SIGNATUREOFCONTFACTOROF/1UTH.AGIiNT OATE <br /> SIDEYARDSETOACK STREETSETDACK REARVAR�SETDAC PLANCHECKNUM�ER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> VSE ZONE LOT APEA VACANT SITE <br /> ❑VES ❑NO FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROVP NO.OF DWELLING <br /> UN'T$ � <br /> S�ZE OF pLDG. NO.OF STORIES MA%.OGC. LOAD BUILDING 5 `+`^'�� 3j � <br /> PLUMp W G � <br /> FIRE 20NE Ll/15EMENT FIRESPRINKLERS � <br /> ft ❑VESED ❑NO MECHANICAL I <br /> SPEC�AL CONDITIONS: OTIiEfl � <br /> I <br /> PENELTY SEC.�071a1 I <br /> TOTAL 31� <br /> PERMIT VALIDATION <br /> WHEN PROPERLV VALIDATED(IN THISSPACEI THI515 VOUR PERMIT <br /> I �%'IICATION/.CClPTE��Y�. PL/+115CIICIXCOOY. AVPpOVfDFOhI55U�NLGOY. <br /> mr <br /> � � <br />