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everett <br />CITY HALL 1SEEEE1 <br />EVEIIETT. WASHINGTON <br />NMI <br />OEET Of <br />G°••uIITY BUILDING <br />DEVEIONIENT <br />...,.... . A , %,, . . .4... <br />PERMIT <br />MECHANICAL <br />PLUMBING <br />OWNER MAIL ADDRESS ZIP PHONE <br />1AIP.FXF TMallCH 252-7% <br />116�-77 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />m <br />PERMIT <br />�yy�� <br />dxUILDING E_PA-LUMBING CILAECHANICAL <br />CLASS OF WORK <br />❑)JEW ❑ADDITION El ALTERATION ❑REPAIR <br />Z <br />F <br />VALUATION OF LWUo RKM <br />4 34LAA 000 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />cc <br />LLf <br />LL <br />DESCRIBE WORK <br />CrMn'r-1 3r!' F F i!lTff ZLI}i0 <br />2975 <br />PROPOSED USE <br />MECHANICAL <br />NAT <br />TYPE OF FUEL ❑OIL ❑GAS ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPE(ETY (SHOW BELOW OR ATTACH <br />FOUR COPIES) ����t( <br />LOT BLOCK__M 'l.1117 L�-' Co/5 U' <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />4 <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />1 <br />JOB ADDRESS <br />21try-K H?GffiAM <br />WALL HEATERS-B.T.V. M <br />UNIT HEATERS-B.T.U. M <br />1 <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGE HOOD <br />1 <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET )TOILET) <br />4 <br />INCINERATOR <br />1 <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />SHOW!" --- <br />KITCH.. N SINK 6 DISP. _ <br />SUBTOTAL 4 <br />DISHWASHER <br />PERMIT 4 <br />LAUNDRY TRAY <br />Fq <br />TOTALFEECLOTHESWASHERS <br />PERMt7 dECOMES NULLAND VOID IF WORK OR CONSTRUC- <br />': ,.,uT NORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUC{ PERIOD OFTION OR WORK IS SUSPENDED OR 1Y0 DAYS AT ANY TIME AFTERABANDONED <br />WORK SCOMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK, WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />% jJ 3/1/77 <br />WATER HEATER <br />URINAL <br />_ <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />--{-- <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />{ <br />SUB TOTAL <br />PERMIT <br />4 <br />_ <br />TOTAL FEE <br />4 <br />SIGNATURE OFCONTRACTOROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />5 <br />STREETSETBACK <br />yy��N <br />REAR YARDSETIIACX <br />y�q <br />r <br />PLAID CHECK NUMBER <br />q Al <br />7 36 <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />T1000 23626 <br />USEZONE <br />5-2 <br />LOT AREA <br />hcoo sqq ft. <br />VACANT SITE <br />OYES [INC) <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF OWE LLING <br />UNITS <br />1 <br />1 <br />BUILDING <br />4 <br />SIZE OF BLDG. <br />e1./+7M <br />NO. OF STORIES <br />7 <br />MA%. OCC. LOAD <br />