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fhc Et�nryiecn <br />CI fY OP <br />everett <br />cirv r�n��zs�a�ar, <br />EVERETT, WA 98201 <br />COMBINATION <br />CONSTRUCTION <br />PERMIT <br />• BUILDING • MECHANICAL • PLUMBING <br />everett <br />OWNEfl MAIL AUDRE;; LP YHONL ,Q <br />'?. A, :'OP.i3T.'S 92� GD.T_,I: PL ui:L'iY, ;�. c:. 1�'It' 1�;2�_ 77G-19CLt � <br />ARCHIiECi OR DESIGNEft MAIL AD�RESS PHpNE LIC[NSE NO. � <br />� <br />GEN[RAL CONTR/1CTOfl MAIL ADDRESS PNONE UCENSE NO. Z <br />s�r c <br />MECHANICAL GONTRACTOR MI11L ADDPE55 PHONE LICENS[ ND. 3 <br />W <br />;.� m <br />PLUMOING CONTRACTOR MML ADD(iE55 PHONE LICLNSE NO. Li7 � <br />117 <br />PERMIT CLASS OF WORK �� <br />� COMDINATION <br />z] �UILDING � PLUMBING � MECHANICAL �y. <br />❑ NGW ❑ ADDITION ❑ ALTERATION L'9REPAIF. <br />VALUA710N OF WORK <br />S 3�0�00 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING PUOL <br />DESCRIBE WORK <br />'f0 PTP:iI'.i IIOi?STI i0 Cii?�PL-31iCF '.!11'!i _�'.1i ': D.^.iL•'� fi�12�%5 <br />PROPOSED VSE <br />MECHANICAL <br />LEGAL �ESGrIIPTION OF PROPENTV ISHOW 13ELOW OR ATTACH TYPE OF [NGfiG V <br />FOVRCOPIE51 ❑GA$ ❑EI.EC. <br />Lo7 OLl1CK_OF NO. TVPEOFEDUIPMENT FEE <br />AIF CON�. UNITS-Ii.P. EA. 5 I <br />RGFRIGEPATIfIN UNITS -II.P. EA. <br />ROILERS II.P.EA I <br />f-OfiCED AIR SVSTEMS-8.7'.U. MEA. <br />I <br />JOB ADDR[SS SPACE & WALL HEATERS - B.T.U. <br />�.C132 [ii{I7��'.� UNIT IILATERS fi.T.U. I <br />_ EVAPORATIVECOOLERS <br />PLUMBING c�on+[� nrsv�as i <br />I VENTIlAT10N FAN —T— <br />RANG@HOOD I <br />NO. TVPE Of FI%TURE OR ITEM FEE AIR HANDLING UNIT C.F.M. <br />�ATNTUBS $ — ------ � <br />CLOTHES Wl�SHER � WATCR REATER <br />DISH WASHEHS i -- -- ------ <br />DRINKING FOUNTAINS � fAC. OUILT FIREPLACE R CHIMNEV I <br />FLOOR ORAINS � _ ���5_=�STEM�. No oP oUTLE75 <br />�— � --' --- SUfiTO�AL 5 I <br />KITCHEN SINKS & DISP. � �_ <br />BAR SINKS —�— PERMI� 5 <br />ROOF DRAINS - RAW LEADERS i TOTnL F[[ 5 � <br />$HOWER UFTHS iHIS PEqMIT pECOMES NULL AND VOID IF WOqK OR CONSTflUC <br />SERVICF SINKS —1�— TION l�UT110(i12BD IS NOT COMM1tENCED WITHIN 120 DAVS, OR IF <br />SUMPS -$EWAGE PUMP I CUNSiHUCiION OF bVORK IS SUSP[NDED OR AUANDONED FOR A <br />— — i— PLRIOD OF 120 Di1V5 ni /�NV TIM11G AF 7[R WORIC IS COMAIENCEO. <br />UFINALS <br />WATEH CLOSETS j ���EPFISv C6fiTl�v 111AT 1 11AVE NEl1D AND EY.AMINED THIS AP- <br />PLICATION /1Np KNOW THE SAM[ TO (3[ TRUE AiVO CORREC7. ALL <br />WATEfi HEATERS -_ELECTRIC � pqoVisiurvs or �nws nNo oivoiNnNCes cov[raNinG THIS TVPE <br />WASH BASINS —j OF WOHK WILL [3E CO.4IVUED WITII WHETHEH tiPGCIFI@O HEREIN <br />LAUNDRV TRAVS Oii NOI�, ili[ GRl�NiING OP 11 P[RMIT OO[S NOT PfiESUME TO <br />� GIVL AUTHORITY TO VIOL/�TE Ofi CANCEL THE PFiOVISIONS OF <br />�__ ANV piHGR STAiE OR LOCAL L�lll' H6GULM-ING CONSIRUCTION <br />� OlY 111L PERFOfiMANCF. OF CONSTRUCTION. <br />_ ' '� ///��� <br />SUB 70TAL —� i� X /� n ���Cs <br />PERMIT 5 � <br />TOTAL FEE_ ��/.�� <br />WATERSERVICESIZE nLD,.SUPPt_YSIZE sicrvniu�aeor-coNrancronar:nun�.nceNr on r-� <br />SIDEVAROS[T�ACK STHCETSETftACK li@ARV4RD$BTfiACKPLI�NCHFCKNUMREfl PLANCIIECKFEE <br />F[E R@C[IPT NO. <br />USE ZONG lOT Ali[A VACANT :I�E <br />❑rEs GNo FEES VALUATION FEE <br />TVPEOfCONST. OCCUPANCVGHOUP NO.OFOWGILING �— <br />UNITS I <br />SIZE OF OLOG. NO. OF STORIES MA%.00C. IOAD I3UIL�ING 5 3�0�� 2 ��O <br />PLUMOiNG 1 �� <br />FIRE20NE UAtiEMENi FIRESPRINKLERS <br />REOUIREO I <br />❑YES ❑NO MCCIIANICAI. 1 <br />SPLCIAL CONDITIONS'. OTHER � <br />I <br />_ <br />--.- - — -- P[Nl�L1Y SEC.JO:tlal I <br />I <br />TOTAL f I <br />PEFMIT VALIDATION <br />-- w��eN Nnor�a�v vn�ionT�u i if� �j�:�sr�nci��Q�f� �.'��TG9Yr."' <br />-- -- <br />— — � YOUR RECE(Pl;,_' <br />,,: <br />�,.���������,�,��:�:����„�,. �•�����,:�,E�:.�„��. �����������><<����:ry,��„��„ � � ';NANK YOU : �� <br />JJ <br />n <br />