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The Evergreen <br />CITY OF <br />everett <br />CITY HALL 299E995 <br />EVE -it". WASHINGTON <br />99201 <br />DEPT. OF COMMUNITY <br />BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e� <br />OWNER MAIL ADDRESS ZIP PHONE <br />;ra';:'?t�L[a'JtC:t 2132 Highland Avenue 92 <br />1164-77 <br />ARCHITECT OR DESIGNER MAIL ADDRE55 PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />-;, D <br />MECHANICAL CONTRACTOR MAIL ADDRE55 PHONE LICENSE NO. <br />cc <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />m <br />PERMIT CLASS <br />BUILDING 19PLUMBING MECHANICAL <br />OF WORK <br />MEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />0 <br />Z <br />~ <br />V ALUATIONljF�'j RJ(� <br />xfu�Jl <br />$ <br />❑DEMOLISH []FENCE ❑SIGN ❑SWIMMING POOL <br />uj <br />W <br />a <br />DESCRIBE WORK C,,,,.'E�"'T ;`'n ✓, [i- 9yry4 (1E�7s�..s <br />7/ 7 <br />`V 1 <br />PROPOSED USE <br />MECHANICAL <br />. ❑LPG. ❑ELEC. <br />TYPE OF FUEL ❑OIL ❑ GAS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES( <br />"-j "`y ;-t1"['`. 1'ijt;i <br />LOT BLOCK �(' <br />F <br />'LPL V s <br />NO. <br />TYPE EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA, <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIq SYSTEMS-B.T.U. <br />JOB ADDRESS ,L <br />A G, <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT- C.F.M. <br />N <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET (TOILET) <br />$ <br />-- <br />BATHTUB <br />1 <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & OISP. <br />SUBTOTAL $ <br />to <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTAL FEE $ <br />1 <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />1 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 GkANTING OF A PERMIT DOES NOT PRFSUME 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 />9/1/77 <br />x <br />WATER HEATER <br />V RINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />_ <br />ROOF GRAINS-R AINLEAOERS <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />$ <br />SIGNATURE OF LJNTRACTOn OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />l7 f% <br />STREET SETBACK <br />2m <br />REAR YARD E BACK <br />f4l�Y <br />PLAN CHECK NUMBER <br />?7AL 6 <br />E f l]� <br />PLAN CHECK FEE <br />FEE RE IP6: b0. <br />USF„ZZWE <br />LQT ME A <br />��(J[j� <br />VACANT SITE <br />DYES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />• 1 <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />BUILDING <br />$ 3h6W.W <br />iL12101D <br />—y <br />SIZE OF BLDG. <br />NO, OF STORIES <br />1 <br />MA K. OCC. LOAD <br />PLUMBING <br />ry <br />L�Pf I`n <br />f-I REZONE <br />3 <br />BASEMENT <br />no <br />FIRESPRINK LERS <br />R ED <br />DYES (ILO <br />MECHANICAL <br />12i0G <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />I <br />-- <br />_— <br />PENELTY <br />SEC. 303(J <br />_ <br />--- <br />TOTAL <br />Ill IOJ <br />- -- - - <br />PERMIT VALIDATION <br />1VHEN PROFS RLY VAT$OAT ED (IN THIS SPACE) THIS IS YOUR PE RNIII <br />luo (D`t'D.9', <br />6V or <br />_ <br />APPLICATION ACCEPTED BY: <br />JPL4NSCHCCKEDBV <br />APPROVED FOR ISSUANCE BY. <br />