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Ihe Evr.ryreen <br /> CITY OF CONSTRUCTION everett <br /> everett PERMIT <br /> cur nnu rs�xses <br /> [Vf N[tl.1YASIIINfJON <br /> 99101 <br /> ����, �� _�^�^������ BUILDING MECHANICAL PLUMBIN <br /> ocvrinrM[xr <br /> MAIL ADDRE55 21P PHONE <br /> O W N E F .i�Lf..OL. <br /> r �""?T': '113.3 ^;•-+r-'� •. .,q .si�ac�caus <br /> ,,. <br /> MALL A�DFESS PHONE VCENSE NO. T11+a � <br /> ARCHITECT OH DESIGNE(i Jr iti� <br /> MAILAOORESS PHON[ LICENSENO. <br /> GENERALCONTRACTOfl �y- /� n •� M 7i�� J '_ \ y_y2�` <br /> ys��•Er� � f�.���n..♦ 9ryN1 �!^�s� --...n} .�i• �u��':7+7 GL3••J...yy.. 1 1 a�i. <br /> r a'.r�a.ti t.:� <br /> MECHANICnL COn1TRACTUR <br /> MAIL ADORE55 PHONE LICENSE NO. <br /> � <br /> MAILl�DORESS P�iONE LICENSENO. �yJ ' <br /> PLUM6ING GONTRACTOR (� <br /> � <br /> PEFMIT CLASS OF WORK z <br /> H <br /> .�]BVILDING �] �'LUMBING �M[CNANICAL �NEW �qDD1TION ❑ALT6RATION ❑FEPAIR � <br /> � <br /> VAIVATION OF WOFK w <br /> ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br /> 5 <br /> DESCRIBE WOfiK 1696 <br /> 1,�Y1 �,T'I'�Ts� "'!�� <br /> PaorosEo use � MECHANICAL <br /> TVPEOFFUEL �OIL ❑GnS ��P�+• ❑ELEC. <br /> LFGAL OESCRIPTION OF 1'flOPEFlT V lSHOW OELOW OR ATTACH <br /> Foua COPiESI ��� NO. TVPE OF EOUIPMENT FEE <br /> LOT� 6LOCK—OF- ��Y'^�-"• qIR COND.UNITS-H.P. EA. S I <br /> REFRIGEfiATION UNITS-H.P. EA. <br /> �O�LERS-H,P. EA. � <br /> GAS FIRED A.C. UNITS-TUNNAGE EA. <br /> FORCED AIR SVSTEMS-�.T.U. M EA. � <br /> JOB ADDRESS . _ W�+LL HEAIERS-A.T.U. M <br /> � '.'L . :f.?t, �'�i� UNITHEATERS-B.T.U. M I <br /> EVAPOPAiIVECOOLERS <br /> PLUMB�NG CLOTHES DRVERS � <br /> VENTILATION FA�' <br /> RANGCHOOD � <br /> AIR HANOLING UNIT- C.F.M. � <br /> NO. TYPE OF FIXTURE OR ITEM FEE iNCiNEan7oR � <br /> WATER CLOSETITOI�ET) � <br /> BATHTUB 1 <br /> LAVATURV (W�15H BASIN) _I.� <br /> SNO�^1Efl SUBTOTAL 5 I <br /> KITCMEN$INK& DISP. pERM1T $ <br /> DISHWASNEF <br /> LAUNDfiV TRAY TOTAL FEE 5 I <br /> GI.OTHES W�+SNEF TF115 PBP�dIT DECOMES NULL ANO VOID IF WORK OR CONSTRUG <br /> WATER NEATER TION AUTHOFI2E� IS NOT GOMM[NCED WITHIN 120 DAVS, OR IF <br /> CONSTRVCTION OR WORK IS SVSPENDED OR /�0�1NDONE� FOR A <br /> URINAL PERIOD OF 12� DAYS AT ANV TIWE AFTER WO(iK IS CUIdMENCFO. <br /> DRINKING FOUNTAIN � HERE[1V GERTIFV THAT 1 HAVE REAO l�ND EXAMINLD TNIS AP- <br /> FLOO(i-SINK OF DFiAIN PLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL <br /> VACUUM1i OREAKEftS — PROVISIONS OF LAWS AND ORUINANCES GOVERNING THIS TVPE <br /> ROOF DRAINS-RAINLEADERS Of- WORK WILL DE COAIPLIED WITH WHETMER SPECII°iED HERE�N <br /> SINK ISEPVICE-6AF. ETC.I OR NOT, TIIE GRANTING OF /1 'EFiM1T DOES NOT PttE5UM11E TO . <br /> �-- ANY O NE�ii�STATETOPvI OCALEIAW REGULATING CO�h'STRUCTION <br /> OR THE PEFiFORMANCE OF CONSTRUCTION. <br /> SUB TOTAL __�I+��. _ <br /> PERMIT 5 �_ <br /> TOTAI FEE 5 ��� <br /> SIGNATUREOFCONTRACTORORAUTH.AGENT OA1E <br /> PI.AN CHECIC F EE <br /> SIOE YAfiD SETOACN STR[ET SETI3ACK REI1R YA�iD SET6ACK PIAN CNECK NUAIOER FEE RECSIPT NO. <br /> 5• `=�' �` 7',;-�a. �l,.o� z?Y33 <br /> USE ZONE^ LOT A�iEA VACANT SITE <br /> .IG ❑vEs I�No FEES VAlUAT10N FEE <br /> TYPE OF CONST. OCCUPANCV GFOVP UNIT�S DWELLING I <br /> Z p��r� /y� <br /> SIZE OF dLDG. NO.OF STORIES MAX.OCG LOnD OUILOING J7K+rW �'��� <br /> PLUM�ING �j�`� <br /> FIflE ZONE BASEMENT FIRESPRINKLERS <br /> qf�UIRED MECHAf11CAL � <br /> 3 ❑VES ❑NO <br /> � <br /> SPECIAL CONOITIONS: OTHER � <br /> PENELTY SEC.�071a) � <br /> 1 <br /> TOTAL (� <br /> PERMIT VALIDATION ! <br /> WHEN PROPEPLV VALIDATED (IN TH65PACE) THIS IS VOUR PEIiM1T <br /> I mrucnrmt�ncurnnxr r�nr¢n�EtK[obr r,vvnovm�oPi�un�¢[.or <br /> �:� C� <br /> � <br />