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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2599995 <br />EVERETT. WASHINGTON <br />99201 <br />DEPT. OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PFRMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNER MAIL ADDRESS ZIP PHONE <br />ARCHITECT OR DESIGNER Mn!L ADDRESS PHONE LICEN9ENU <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />54DRT rl,'Oo 14CM 3 th :i t *AM, ^Md911•t+5tti <br />MECHANICAL CONTRACTOR MAIL ADDRESS P114NE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cc <br />Ui <br />to <br />PERMIT <br />QBUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION WEPA1R <br />Z <br />H <br />VALUATION OF WORK <br />S .�J0 <br />M <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />cc <br />W <br />a <br />DESCRIBE WORK <br />`�? (r'I <br />1584 <br />PROPOSED USE <br />MECHANICAL <br />DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />LEGFOU <br />FOU�C�PI ES) a <br />LOT BLOCK-L OF TOWAIM AiNL. <br />TYPEOFFUEL ❑OIL QNAT. ❑LPG. ❑ELEC. <br />GAS <br />NO. <br />TYPE OF 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 AIR SYSTEMS-B.T.U. M EA. <br />I <br />JOB ADDRESS <br />l� <br />` W 1 -AsW <br />PLUMBING <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />FVAPnRATIV£ COOLERS <br />1 <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) <br />§ <br />INCINERATOR <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK P. LISP, <br />SUBTOTAL S <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTAL FEE $ <br />I <br />CLOTHES WASHER <br />WATER HEATER <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 />I HEREBY CERTIFY THAT 1 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 />X <br />URINAL <br />DRINKING FOUNTAIN <br />- <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-R AINLEADE RS <br />-�— <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />$ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />WO. OF DWELLING <br />UNITS <br />I <br />BUILDING <br />S T25-/h <br />a b0 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />RCOUIRED <br />OYES ONO <br />MECHANICAL <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENELTV <br />SEC. 00310) <br />TOTAL <br />is <br />-- - - <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIC SPACE) THIS IS YOUR PERMIT <br />u <br />'PPLICATION ACCEPTED BY PLANSCIICCKEDDY APPROVED <br />FOR IMUANCE BY. <br />La <br />