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the Evergreen <br />CITY OF <br />WNSTR UCTION <br />everett <br />PERMIT <br />everett <br />CRY HALL 2$99ee5 <br />EVERETT. WASHINGTON <br />9E201 <br />DEPT. OFVE <br />BELOPMENT BUILDING MECHANICAL PLUMBING <br />OWNER <br />16 Soran oa 141.10 :t=4 <br />MAIL ADDRESS ZIP PHONE <br />ARCHITECT OR DFS) G N E R <br />MAIL ADDRESS PHONE LICENS_EN 0. Caf9+(U <br />GENERAL CONTRACTOR <br />MAIL ADDRESS PHONE LICENSE NO, <br />ME�CyH.A.N�I�C(.A.L.. C�Or,.N_T R�A�CT�OR <br />CI <br />MAIL ADDRESS P4_OU�N EE <br />',iuQut ��j LLIICCEENSSEE NNO.. <br />i � 14 lw. ftIi <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS PHONE <br />ir <br />LICENSE NO. <br />W <br />PERMIT <br />OF WORK <br />mCLASS <br />2 <br />D <br />[:]BUILDING PLUMBING <br />❑ <br />Z <br />MECHANICAL <br />a <br />NEW ❑ADDITION L]ALTERATION ❑REPAIR <br />� <br />VALUATION OF WORK <br />$ <br />❑DC:.IOLISH ❑FENCE El SIGN ❑SWIMMING POOL <br />cc <br />W <br />DESCRIBE WORK <br />CL <br />nwtn la'sw <br />1545 <br />PROPOSED USE <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH TYPE OF FUEL ❑OIL ❑GAS, ❑LPG. ❑ELEC. <br />FOUR COPIES) <br />LOT BLOCK —OF <br />NO. TYPE OF EOU:PMENT FEE <br />AIR CONO. UNITS-H. P. EA. $ I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. I <br />GAS FIRED A.C. UNITS -TONNAGE E <br />JOB ADDRESS <br />FORCED AIR SYSTEMS-B.T.U. M EA. «� <br />— I <br />2� <br />WALL HEATERS-B.T.U. M <br />N <br />UNIT HEATERS-B.T.U. M I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />- CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) <br />$ INCINERATOR <br />BATHTUB <br />I <br />LAVATORY (WASH BASIN) <br />SHOWER <br />I <br />KITCHEN SINK A, DISP. <br />SUBTOTAL $ <br />I <br />DISHWASHER <br />LAUNDRY TRAY <br />PEHMIT 5 <br />CLOTHESWASHER <br />I <br />TOTALFEE $ <br />I <br />WATER HEATER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 <br />URINAL <br />DAYS, OR IF <br />OR ABANDONED FOR A <br />PERIOD OFTION 120 DAYS ATR ANY TIME ADFTER WORK IS COMMENCED. <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 />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT $ <br />TOTAL FEE $ <br />SIGNATUREOFCONTRACTOROR AUTH.AGENT DATE <br />SIDE YARD SETBACK STREET SETBACK <br />ATARD SETBAC <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VAC" SITE <br />❑NO <br />FN <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />WELLING <br />FEES <br />VALUATION <br />FEE <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />C. LOAD <br />BUILDING <br />$ <br />I <br />I <br />PLUMBING <br />I <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />REQUIRED <br />MECHANICAL <br />71W <br />❑YES ❑NO <br />SPECIAL CONDITIONS: <br />I <br />I <br />OTHER <br />PENELTY <br />SEC. 303(B) <br />I <br />TOTAL <br />IQ� <br />_ <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />APPLICATION ACCEPTED BY: <br />PEANSCNECKED BY: J_APPR5VC`Fffif`P=ANCE <br />11 <br />