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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 255 H18$ <br />EVERETT. WASHINGTON <br />99201 <br />DEPT. OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �.e� <br />OWNER MAIL ADDRESS ZIP PHONE <br />ITATT PlIfI ,.,,,PEN 3,W ...�T. <br />���� <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />ioE <br />cc <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Ul <br />m <br />2 <br />PERMIT <br />[]BUILDING []PLUMBING MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION fDREPAIR <br />D <br />Z <br />~ <br />VALUATION OF WORK <br />5 <br />❑DEMOLISH []FENCE ❑SIGN ❑SWIMMING POOL <br />cc <br />LU <br />2 <br />DESCRIBE WORK <br />!kt, W.AU W- W <br />1071 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑ ❑LPG. ❑ELEC. <br />GAS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <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 />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />I <br />JOB ADDRESS <br />�V�Y7 <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />1 <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATII,ir r.NN <br />RANGE IIOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINE hATOR <br />I <br />WATER CLOSET (TOILET) <br />e; <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUBTOTAL S <br />I <br />DISHWASHER <br />PERMIT S <br />LAUNDRY TRAY <br />TOTAL FEE 5 <br />I <br />CLOTHES WASHER <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 ALANDONED FOR A <br />PERICD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CO:IRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING (:HIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HIEPFIN <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 />Th4% <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />5 <br />TOTAL FEE <br />5 <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REARYARDSETBAC' <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES []NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNO. OFNITS OWELI.ING <br />UNITS <br />—I <br />BUILDING <br />$ <br />1 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />1 <br />FIRE ZONE <br />BASEMENT <br />FIRESPR I NKLERS <br />REQUIR ❑Y SED ONO <br />MECHANICAL <br />.P� <br />'lloo <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />I <br />PENELTY <br />SEC. 303 (B) <br />1 <br />TOTAL <br />'! I <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />3 <br />AF'PLICATIONACCEPTEDBY. <br />PLANSCHECKEDBY. <br />APPROVED DRISSUANCEBY. <br />Q� <br />