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the Evergreen <br /> ���� �� CONSTR l!i;TION everett <br /> everett PERh4lT <br /> ❑iv IIAII 1598PB5 <br /> EVCNEIi,1YASNING111N <br /> 9P}pl <br /> °`°"��`�'�;o�'�;,", BUILDING MECHANICAL PLUMBING a <br /> OWNE�R-yyp�p/y� �y�p MA�I�LA+,Dy�O�RE55 ZIP PHON@ <br /> � 4:➢tx:("WiL �JV 1N��.1�3f 6VPY? <br /> A(iCliITECT OR DE,^.IGNER MAIL ADDRE55 PHONE LICENSE NO. <br /> GENEHAL CONTRACTOR MAIL AOORESS PHONE LICENSE NO. <br /> MgECNANICAL CONTRqCTOR MAIL ADDRESS PHONE LICENSE NO. I <br /> Y �S � <br /> PLUM6ING CONTRACTOR MAIL ADDFESS PHONE LICENSE NO. W <br /> m <br /> PERMIT CLASS OF WORK � <br /> � <br /> ❑ �UILDING ❑ P�UMBING �MECHANICAL z <br /> ❑N[W ❑A�DITION ❑AI.TERATION �REPAIR ~ <br /> VALUATION OF WORK � <br /> 5 ❑UEMOLISN ❑fENCE ❑SIGN ❑SWIMMING POOL W � <br /> �ESCRIBE WORK }�}����S <br /> a <br /> .Jt��.l�fY1iIJ tih �v .�iy... iOT <br /> PROPOSED USE <br /> MECHANICAL <br /> LFGALDESCRIPTIONOFPROPLftTVI5HOW8ELOWORATTACN TYPEOFl�U[L �OIL ❑GrS �LpG. �ELEC. <br /> P OU R COP�E51 <br /> �or BLOCK_oF NO. TYPE OF E�UIPMENT FEE <br /> AIR COND. VNITS-H.P. EA. 5 I <br /> REFRIGERnTION UNITS-N.P. EA. <br /> 601LER5-H.P. EA � <br /> Gl�S FIFED A.C. UNITS-TONNAGE EA, <br /> PORCED AIR SVSTEMS-B.T.U. M EA. � <br /> JOB ADORE55 t WqLL HEATEFiS-U.T.U. M � <br /> UNI" HEATERS-O.T.V. M � <br /> EVAPORATNE COOLERS <br /> PLUMBING CLOTH[SDRYERS � <br /> VENTIL�ITION FAN <br /> flANGEHOOD � <br /> NO. TVPE OF FIXTURE OR ITEM FEE ��� HANDLING UNIT- C.F.M. <br /> WATERCLOSET�TOILETI �NCI EH TOR <br /> BATHTUB 5 { I a � <br /> _ LAVATORYIWASMBASIN) � — <br /> SHOWER <br /> KITCNEN SINK & DISP. SUD TOTAL 5 <br /> �ISHWASHER — — <br /> LAUNDRVTRAY PERMIT 5 <br /> CLOTHES WASHEIi TOTAL FEE 5 <br /> WATE(i HEATER THIS PERMIT 'ECOMES NULL AND VOIO IF WORK OR CONSTRUC <br /> -- TION AUTHOR.ZED IS NOT COMAtENCEO WITHIN 120 DAVS, OR IF <br /> URINAL CONSTqUCTION OR WORK IS SUSPENOEO OR AOANOONED FOR A <br /> ORINKING FOUNTI�IN PERIOD OF 120 DAYS AT FNV TIM11E AFTER WOPY. Iti COM1I�:ENCED. <br /> FLOOR-SINK OR DRAIN I HEPE6Y CERTIFY THAT 1 HqyE flEAD AND E%AMINED TNIS AP- <br /> VAGUUM PREAKEflS PI.IJATION AN� KNOW THE SnML 1'O C1L TRUE AHO CORIiECT. ALL <br /> ROOF DRAINS-�qq�NLE:�OERS FqOVIS10N5 OF LAWS AND ORDINANCES GOVEFNING THIS TVPE <br /> OF WOftK WILL pE COM1iPLIED IVITH WNETHER SPECIFIED HEflEIN <br /> SINK (SERVICE-BAR, ETC.) OR NOT, THE GRANTING OF A PERMIT DOES NOT PqESUME TO <br /> GIVE AUTHORIT\' TO VIOLATE OR CnNCEL THE PROVISIOhS OF <br /> ANV OTHER STATE OR LOCAL LAW F`EGVLATING CONSTl�UCTION � <br /> OR THE PERFORMANCE OF CONSTRUI;TION. <br /> SUOTOTAL <br /> PERMIT 5 <br /> TOTALFEE 5 <br /> x �� <br /> SIGNATUREOFCONTRACTORORAUTH.AGhNT �A"(E <br /> SIOE Yl1liD SETOACK STREET SETBACK FEAR T'AROSET�ACK PL�IN CHECK NU�iDER PLI�N CIIECK F@E <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AHEA VACl.NTSITE <br /> ❑VES ❑NO FEES V,\LUATION FEE <br /> TVPE OF CONST. OCCUPANCV GFOUP NO.OF DWELLING F — <br /> UNITS � <br /> S12E OF BLOG. NO.OF STONIES MAX.00C. LOAO BUILDING $ I <br /> I <br /> PLUMBING I <br /> FIRE20NE E3ASEAIENT FIFESPRINKIERS <br /> REOUIRED ��— <br /> ❑YES ❑NO MECHANICAL <br /> SPECIAL CONDITIONS: OTHER I <br /> I <br /> — PENELTY � SEC. 30J(a) I <br /> TOTAL � <br /> I <br /> PERMI,-VALID.>TION <br /> WI�`N FROPERLV VALIDATED IIN TIIISSPACE! THIS IS YOUR PERAtIf <br /> nPl`IIC�TION�CCCPTE�OY�. GL�N501[CNCOOV. TFPOOVE�FOAi:5U�6CE0Y. <br /> I <br /> 3 I <br /> • <br /> � <br />