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lheEvergreen � - - C'�NSTRUCTION � � �`'� � <br /> CITv OF <br /> everett PERMIT pERMIT NO. OS731 <br /> CITY HALL 259�8745 <br /> EVEFETf.WA 98201 ❑ COMBINATION ❑ BUILDINO ❑ MECHANICAL ❑ PLUMBIN(i . <br /> OWNEH MAIL RDDRESS piV 21P �'MONE <br /> F K SHFnRC ii�R uFrvC nn ctscncmm �a oo�n� �5;-�Q�f' � <br /> ARCNRECT OR O[SIGNER MAIL ADDRESS CIiY 21P PHONE <br /> � GENERAL CONTRACTOR MAII ADDRESS GITV 21P �'HONE IIGENSE I <br /> MECHRNIGL CANTPACTOP MAIL ADUHE55 CIiY 21P PHONE IICENSE/ <br /> SEL�` <br /> PWAIBINGCONTRRCTOR MqIRDDNESS CITY ZIP FMONE I�CENSlI <br /> ClA55OF WOIiN <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION �FENCE ❑SIGN OGARAGE � <br /> VALU�TION Oi WORN <br /> f <br /> OESCRIBE WORK <br /> °AOPOSED USE O�BUILOING <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br /> lECylDESCRIPT10NOFPpOPERTY�SHOWBELOWORATTACHFOURCAFIES� PLICATIUN AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �o.__e�oc�_oF TYPE OF WORK WILL BE CQMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRU TION O�PORMANCE OF CONSTRUCTION. <br /> JOB ADORESS SIGNATU F i N FUTHORIZED RGENT OPTE <br /> 828 P ' <br /> PIUMlINd MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE N0. TYPE OF ECUIPMENT FEE <br /> WATER CL0.SET 1i711 AIR CANC UNITS—H.P.EA. . <br /> B,4THTUB REFRIGEMTION UNITS—N.P.EA �. <br /> • UVATORY ASH BASIN) BOILERS—HP.EA. �; <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B 7.U. M EA. <br /> DISHWASMER WALL HEATERS—B T.U. M <br /> � �. UUNDRV TRAV UNIT HEATERS—B.T.U. M <br /> � CLOTHES WASHER EVAPoRATIVE COOLEPS <br /> . WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> . FLOOR DRAIN AIF HANDLING UNIT— C.F.M. . <br /> VACUUM BREAKERS S70YE � <br /> ROOF DRAINS—RAINLEADERS METAL FIREPIACE 8 CHIMNEV � <br /> SINK I�FRYICE—BAR.EfC.I <br /> SUe Tpiw SU!TOTAL f <br /> PERMR 3 PEqM1T f <br /> TOTAL FEE { TOTALFEE <br /> SIDE YMD SFTBACK S7REET SETBACK REAR VARD SETBNCK PIAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPi NO. <br /> USE ZONE LOT RHEA �ACANi SITE <br /> ❑VES l]NO FEEB VALUATION FEE <br /> TVPE OF CONSi. OCCUPANCY GROUP N0.OF DWELIING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. N0.OF STOPIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED � <br /> �YES ❑NO <br /> AyMpyALB !Y DATE O7MER <br /> 1. ENVIROHMENTAI CHECK LIST pEN��Ty U.B C. <br /> SEC.303(a) <br /> 2. BUIIDING PUNS <br /> � 9. FIRE HYDMNT TOTAL 7 50 <br /> �. FIRE PHOTECiION SVSiEM PERMR VALIDATION <br /> WHEN PHOPERLV VFLIDATED(IN THIS SPACE)7MIS IS VOUR PERMIT <br /> 5. GMDING 1 3 � Z � O O 1, 5 O .� � <br /> 6. DRAINAGE <br /> 7. ENVIRONMENTnL�MPACTSTATEMENT � <br /> 8. HEALTH DISTRICT • • ; n � <br /> APPLICATION ACC.AV Pt/.V$CHECNED BV APPH.FOR�SSUANCE BY � � ��` ��`C E I PT � <br /> • ;, � ,� �.•�, � <br /> ew vc vc <br /> ADDRESS FILE — 2 ��r� 8 � <br />