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!he Evergreen <br /> ��TYo� CONSTRUCTION eve+�ett <br /> everett PERMIT <br /> UiY1�All }59BAA5 <br /> (VEN[il.l'IASNMf.tflN <br /> �eaai <br /> °��T °� �°"°��°^� BUILDING MECHANICAL PLUMBING <br /> n[v[iorratvr <br /> OWNER MAILADD9E55 ZIP PMONE <br /> �'OC ?�• `'�iti[7! �! P4C1.'II :�P� �•'.'}� '���J�1 �.y l <br /> APClIITECTOROESIGNEfi MAI�ADDRCSS PHONE LICENSENO. .yj[J�.Y� <br /> GENERAI CONTFACTOR Ml11L ADDRI:55 PIiONE LICENSE NO. <br /> � <br /> MECHANICAL CONTRACTOR MAIL ADDFiCSS PHONE LICENSE NO. <br /> PLVMUING CONTRPCTOF MAIL ADDRESS PHONE LICENSE NO. � . <br /> W <br /> m <br /> PERMIT CLASS OF WORK � <br /> z <br /> �OVILDING � PLUMOING �M[CHANICAL � <br /> ❑NEW ❑A��ITION ❑ALTERATION ❑REPAIR � <br /> VALVATION OF WORK � <br /> 5 NRYt fV1 ❑DEMOLISH QF[NCE ❑SIGN ❑SWIM1IMING POOL a <br /> s�ilKr/ <br /> DESCRIBB WOFK <br /> �e =��oa �'re� — ��oar �.*� �. �5�an a�:x� �c.;,�: _ 7� 1302 <br /> Paoroseo use MECHANICAL <br /> LEGAL DGSCRIPTION UF PROPERTV ISI10W �ELOW OR ATTACH TVPC: OF FUEL �OIL ❑GAS ❑L�'G. �ELEC. <br /> FOUR IES) <br /> LO7 EiLOCK—oF � ���� NO. ---- TVPE OF EQUIPMENT FEE <br /> AIR COND.UNITS-H.P. EA. 5 I <br /> REFNIGEFATION UNITS-H.P. EA. <br /> OOILE(i5-II.P, EA. I <br /> G�5 FIRED A.C.VNITS-TONNAGE EA. i <br /> FORCED Alq SVSTEMS-D.T.U. M EA. I <br /> JOd AODRESS Wl�LL HEATERS-E3.T.U. M <br /> � � � UNIT HEATERS-9.T.U. M I <br /> [VAPOfiATIVE COOI[RS <br /> PLUMBING c�oTiies DflVEFS i <br /> VENTILATION f-AN <br /> RANGEHO00 � <br /> NO. TVPE OF FIXTURE OR ITEM FEE AIR HANDLING UNIT- C.F.M. <br /> WATER CLOSET�TOIIET) 5 INCINERATOR I <br /> BATIiTU� <br /> �AVATORV(WASII �ASIN) � <br /> SHOWEfl <br /> I:ITCIiEN SINK&OISP. SUO TOTAI 5 � <br /> DISHWASHER PERMIT 5 <br /> LAUNDflVTRAY TOTALFEE 5 I <br /> CLOTHEStVASNER TIiIS PERMIT �ECOMES NULI AND VOID IF WORK OR CONSTRUC- <br /> WATER 11EAT[R TION AUTHORIZED IS NOT COMMENCGO WITHIN 120 DAVS, OR IF <br /> URINAL CONSTRUCTION OF WORK IS SVSPENDED OP ABANOONED FOR A <br /> �RINKING FOUNTAIN PERIOO Of- 720 DAVS l�T ANV TIME AFTER WORK IS COMA9EtJCED. <br /> FLOOF-SINK OR ORAIN I HEREDV CEFTIFY l'HAT I NAVE ftEl�D AND EKAM17IN[D THIS AP� <br /> VACUUM f3REAKERS PLICATION AND KNOW THF SAM17E TO OE TRUE AN� CORRECT. ALL <br /> PROVISIONS OF LAWS 11ND OFIOINANCES GOVFRNING THIS TVPF <br /> qOOF DRNNS-PAINLEAOERS OF WOi1K WILL UE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> SINK (SERVICE-BAR, ETC.) OR NOT, TNL GRANTING OF A PERhilt DOES NOT PR[SUh1E TO . <br /> GIVE AUTHORITI' TO VIOLATE OR CI�NCEL THE PROVISIONS OF <br /> ANV OTH[R STATE OR LOCAL LAW REGULATING CONSTRVCTIOh <br /> OR THE P@RFOPMl�NCE OF CONSTRUCTION. <br /> SUB TOTAL ' <br /> PEFP.IIT 5 <br /> TOTALFEE S <br /> X f��7� <br /> SIGNATUREOFCONTPACTOROR/1UTM.AGENT OATE <br /> SIDEVAFlDSETOACK STRECTSETOACK REARVAROSETOACKPLANCHECKNUMBER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VAGANT SITE <br /> ❑vES ❑No FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING —�— <br /> UNITS � <br /> SIZFOF �L�G. NO.OFSTORILS MA%.00C. IOA� OUILOING 5 �'.W�W �I� <br /> PLUMOING � <br /> FIRE20NE (3A5[MENT FIHESPNINKLERS � I <br /> RCOUIRED <br /> ❑VES ❑ND MECHANICAI I <br /> SPECIl1L CONOITIONS: OTHER � <br /> I <br /> PENELTY SEC. 7071a1 � <br /> I <br /> TOTAL �IQ[� <br /> PERMIT VALIDATION <br /> WHEN P(i0�'@I1LV VALIDATED UN THIS SPACEI THIS IS VOUR PER�11T <br /> AvvUC�TIOtIPCfIP11011Y �IA115fHffN[OIIV FPPPOViB.lOIYISSU/.NCCNY. <br /> 1 q <br /> n <br />