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the Evergreen <br /> ��T� �� CO�:STRUCTION everett <br /> everett P��MIT <br /> Citt NaLL ]59BBB5 <br /> [VEPE11,WASNINGION <br /> 98101 <br /> °E°' °` �°MN°�^° BUILDING MECHANICAL PLUMBING <br /> oevc�ovnrtxr <br /> 01YNER MAIL AODFE55 21P PHONE <br /> 't�lOrl9� 7.�T QBICPO <br /> ARCHITECTOROESIGNER MAILADURESS PHONE � LICENSENO. 1,����i <br /> �ENERALCONTRACTOF MAILAODRE55 PHONE LICENSENO. <br /> Qd t�ui.ldmrs 2.'b9 ra�..tl�o-�-nta >� 33?9 <br /> MECMANICALCONTRACTOR MAILADDRESS PHONE IICEN5EN0. <br /> PLUMBING CONTRACTOR MAII.ADDRESS FHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLASSOF WORk � <br /> Z <br /> ❑BUILDING � PLUMBING �MECHANICAL �EW ❑ADOITION ❑ALTERATION ❑REPAIR ~ <br /> VALUATION OF WORK � <br /> $ ❑DEMOLISH �F@NCE ❑SIGN ❑SWIMMING POOI a , <br /> DESCRIB[WORK <br /> ?� !YitY aDQ qOS4{�7q GC l�'� fllcie �'pIT t�d T72'� i?aI'Ri32 �� 15 51 <br /> PROPOSEO USE <br /> MECHANICAL <br /> TVPEOFFUF.L �OIL �NA-f. �LPG. �EIEC. <br /> LEGAL DESCRIPTION OP PROPEFTY ISFIOW [3ELOW OR ATTACH G45 <br /> FOUF���qfy IES) <br /> �07 "^� BLOCK�or-_�� � �� NO. TYPE OF EUUIPMENT FEE <br /> AIRCOND.VNITS-H.P. EA. 5 I <br /> REFRIGERATION U�UTS-H.P. EA. <br /> BOILERS-H.P. EA. � <br /> GAS FIRED A.G UNITS-TONNAGE EA. <br /> PORCED AIR SYSTEMS-B.T.U. M EA. � <br /> JOB ADDRESS WALL HEATERS-d.T.U. M <br /> � � � UNIT HFAI ERS-B.T.U. M I <br /> EVAPOR4TIVECOOLERS <br /> PLUMBING CI.OTHES DRYERS I <br /> VENTILATION FAN <br /> RANGEHOOD I <br /> AIR HANDLING UNIT 0.F.M. <br /> NO. TVPE OF FIXTUNE OR ITEM FEE - <br /> WATERCLOSETITOILET) � INCINERATOR I <br /> BATHTUB <br /> LAVATORY(WASHBASIN� I <br /> SHOWER <br /> KITCHEN SINK& DISP. SUB TOTAL 5 � <br /> OISHWASHER ' PERMIT 5 <br /> LAUNDRV TFAV TOTAL FEE 5 I <br /> CLOTHES WASHER � TNIS PERMIT BECOMES NUI.L ANO VOID IF WORK OR CONSTRUC- <br /> WATER HEATER -T TION AVTHORI2ED IS NOT COMMENCED WITHIN 120 DAVS, OR IF <br /> URINAL --� CpNSTFUCTION OP WORK IS SUSPENDCD OR ADAh!DONED FOF A <br /> DRINKING FOUNTAIN PEFlIOD OF 120 DAYS AT ANY TIhtE AFTER WORK IS COMMENCEO. <br /> FLOOR-SINK OR DRAIN 1 HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS AP- <br /> VACVUM BREAKERS PLICATION �1ND KNOW TNE SAME TO �E TRUE AND CORRECT. ALL <br /> ROOF DRAINS-RAINLEADERS P��VISIONS OF LAWS AN� ORDINANCES GOVERNING THIS TVPE <br /> OF WORK WILL BE COMPLIED WITH WHETMER SPECIFIEO HEREIN <br /> SINK(SERVICE-BAR, hTC.) Ofi NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITV TO VIOLATE OP CANCEL THE PROVISIONS OF <br /> ANV OTIIER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> OR THE PEPFORMANCE OF- CONSTRUCTION. <br /> SVBTOTAL <br /> PERMIT 5 <br /> TOTALFEE S <br /> x <br /> SIGNATUREOFCONTRACTOROfiAUTH.AGENT DATE <br /> SIDE YARD SETBACK STREET SETOACK REAq VARD SETBAC PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE FECEIPT NO. <br /> USE ZONE LOT AREA VACl�NT SITE <br /> ❑VES ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPl�NCV GROUP NO.OF DWELL�NG <br /> UNITS . I <br /> 512E OF ULDG. NO.OF STOFIES M19A%.OCC. LOAD eUILDING 5�(�� ��W <br /> PLUM8ING � <br /> FIREZONE BASEMENT FIRESPRINKLERS l_ <br /> R ❑VESEO ❑NO MECHANICAI � <br /> SPtCIALCONDITIONS: OTHER � <br /> I <br /> PLNELTV SEC.3031a) I <br /> TOTAL �� <br /> PERMIT VALIDATION <br /> WHEN 1'ROPEFlLY VALIDATE� (IV THIS SPACEI THIS IS YOUR PERMIT <br /> �PPLICAIiONhCLfPTCOPY VLANSLH[CNCOOY Ai'POOVCpfO(iI55Ur1NCE9Y. <br /> � .. <br /> � <br />