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a <br /> the E��ergrr.en <br /> =,TYo�: CONSTRUCTiON everett <br /> everett PERMIT <br /> tliv IIAiI )59E885 <br /> fVEPlit.lYA91iNG10N <br /> 99NI <br /> °"` °"°",",°""" gUILDING MECHANICAL PLUMBING <br /> oEv[iuv��cxr <br /> OWNER MAILADDRE55 ZIP PIiONE <br /> T�'t� I?T*..1', 2It],5 �'.^,!T` 1t�SG-76 <br /> ARCHITECT UR DESIGNEq MAII.ADUqE55 PHONE LICENSE NO. <br /> GENERAL CONTfiACTOR MAIL ADDRE55 PHONE LICENSE NO. <br /> �rT� ��i<�r'.?'�'�• <br /> MECHANICAL CONTHACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> PLVMBINGCONTRACTOR MAILADDRE55 PHONE �ICENSENO. � <br /> W <br /> m <br /> PERMIT CLASSOFWORK � <br /> � <br /> �OUILDING �PLUM6ING ❑MECHANICAL Z <br /> ❑NEW ❑ADDITION ❑ALTERATION �REPAIR ~ <br /> VALUATION OF WORK � <br /> $ �0.� ❑DEMOLISH ❑FGNCE ❑SIGN ❑SWIMMING POOI. W <br /> DESCRIBE WORK a <br /> �,� C�*z�) 17 8 8 <br /> PqOPOSED VSE � <br /> MECHANICAL <br /> T�PEOFFUEL '�OIL �NAT. �LPG. �ELEC. <br /> IEGAL DESCRIPTION Of- PqOPEftTV �SHOW pELOW OR ATTACH GAS <br /> FOVRC PIES) r� <br /> LOT�ULOCKS�OF ��T+��:i �S NO. TVPEOFE�UIPMENT FEE <br /> AIR CUND. UNITS-H.P. EA. 5 � <br /> REFRIGERATION VNIT$-H.P. EA. <br /> BOILERS-'.P. EA. � <br /> GAS FIRED A.G VNITS--TONNAGE EA. <br /> fC RCED AIR E Y$TEMS-D.T.U. M EA. � <br /> JOB AODRESS <br /> ���r WALL HEATEPS-�.T.V. M <br /> Y3i7 V� UNIT HEATERti-B.T.U. M � <br /> PLUMBING EVAPORATIVECOOLERS <br /> CLOTFIES DftVERS � <br /> VENTIL/1TION FAN <br /> RANGENOOO � <br /> NO. TYPE OF FIXTURE OR ITEM FEE �+�R HANDIING UNIT- C.F.M. <br /> WATER CLOSET(TOILETI 5 INCINERATOR � <br /> OATHTUB � '� <br /> LAVATORV�WASHBASIN) � <br /> SHOWER <br /> KITCHEN SINK& DISP. SUO TOTAL 5 � <br /> OISHWASF'ER <br /> LAUNDRV TPAV PEfiMIT 5 <br /> CLOTHES WASHER TOT�11. FEE 5 � <br /> WATER MEATEFi — TNIS PEFId1T 6ECOMES NUIL ANO VpID IF WORK OR CONSTRUG <br /> - TION AV-�HOAI2EO IS NOT C0�1M11ENCED WITHIN 12U OAVS, OR IF <br /> UHINAL CONSTR:ICTION OR WOiiK IS SUSPEN�ED OR A�AN�ONEO FOR A <br /> DRINKING FOUNTAIN PERIOp OF 120 DAVS AT ANV TIME A'rTER WO(iK IS COMMENCED. <br /> FLOOR-SINK OF DRAIN 1 HEREOV CERTIFY TN�IT 1 HAVE REA� AND E%AIdINED 7'HIS AP� <br /> VACUUM OREAKERS P��CATION AND KNOW TNE SAME TO �E TRUE ANO CORRECT. ALL <br /> NOOF DFAINS-RAINIEADERS P�70JISIONS OF LAWS AND OfiOINANCES GOVEqNING TNIS TIPE <br /> OF \VORK WILL BE C0�IPLIED WITH WHETHER SPECIFIED NEREIN <br /> SINK (SERVICE-�AR, ETC.) OR kOT, THE GRANTWG OF A VERh11T OOES NOT PRESUME TD <br /> GIVE '.UTNORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTFIGR STATC- OR I.00AL LAW REGULATING CONSTflUCTION <br /> OR THE PCRFORMANCE OF CONSTRUCTION. <br /> SUB TOTAL I <br /> PERMIT $ � <br /> TOTAL FEE $ ,� �: /y� <br /> x . � / / ' � � .��-`,'rti-� ���/�y <br /> SIGNATVREOFCOhrqpCTORORAUTH. AGENT DATE <br /> SIDEY<\RDSETOACK STREETSETBACK REARYARDSETBACKPLANCNECKNUMR[R PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> ❑VES ❑No FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GROVP NO.OF OWELLING <br /> UNITS � <br /> 512E OF �LDG. NO.OF STORIES MA%.OGC. IDAD BUILDING $ 1.f�.M An I� <br /> �a+wN� � <br /> t- <br /> PLUMBING 1 <br /> FIRE ZONE dASEMENT fIRESPRINI:L[RS � <br /> Rf�UIRED <br /> ❑YES ❑NO MECHANICAL � <br /> SPECIALCONDIilONS: OTHER � <br /> _ � <br /> — PENELTY SEC. 703(0) I <br /> TOTAL r�� <br /> a <br /> PERMIT VALIDATION <br /> WHEN PAOP[RLY VALIDl�TED UN THIS SPAC@)THIS IS VpUR PEHMIT <br /> �PPIICqTIONACCCPtE�BV: PLnNS[IIEC�C�tlV�. ql'POOVCD1011iS5UANCCIIV. <br /> 3,. C� <br /> a <br />