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i <br /> dre Evergreen <br /> CITYOF CONSTRUCTION everett <br /> everett PERMIT <br /> ❑iY11ALL 898845 <br /> EVEPEit,WFSNINGiON <br /> 9l101 <br /> °�^' °' °°^'�°�'TM BUILDING MECHANICAL PLUMBING <br /> ONElOPM11[Nl <br /> OWNER �} ���ry� MAIL AD�RE55 21P PIiONE �y� <br /> C� +.N t�+��� i+F'1i D�.Ni.J a+`"r� � <br /> ARCH�TECT OR DESIGNER MAIL ADDRESS �HONE LICENSE NO. <br /> .� <br /> GENERAL CONTfiACTOR �x�pr� MAIL ADDFESS PIiONE LICENSE NO. <br /> C� ��•ji1�' � J� '�+.il'1xN/ <br /> MECHANICAL CONTRACTOR MAIL AODRE55 PHONE LICENSG NO. <br /> PLUMBING CONTRACTOR MAIL AODRESS PHONE LICENSE NO. � <br /> W <br /> , m <br /> � <br /> PERMIT CLASSOFWORK � <br /> Z <br /> �OUILDING � PLUM6ING �MECNANICAL F <br /> ❑NEW ❑ADDITION ❑ALTERATION �EPAIR � ' <br /> VALUATION OF WORK K <br /> g •Ol�ll_M ❑DEMOLISH ❑FEf�CE ❑SIGN ❑SWIMMING POOL a <br /> a�MT�r <br /> DESCRIBLWORK ��lK �r�� 1054 <br /> PROPOSED USE MECHANICAL <br /> TYPEOFFUEL �OIL �N/1T. �LPG. �ELEC. <br /> LEGAL DESCRIPTIOP!OF PROPERTV ISI�OW�ELOW OH nTTACH GAS <br /> FOUR CO IES) � � � <br /> �o7� BLOCK�F NO. __TVPEOFE�UIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. S I <br /> REFRIGEPATION UNITS-H.P. EA. <br /> BOILERS-Ii.P. EA. I <br /> GAS FIfiED A.C.VNITS-TONNAGE EA. <br /> FORCED AIR SVSTEMS-[3.T.U. M EA. I <br /> JOB AODRESS WAIL MEATERS-B.T.U. M <br /> UNITHEATERS-O.T.U. M I <br /> EVAPORATIVECOOLERS <br /> PLUMBING CIOTHES DRVtRS i <br /> VENTILATION FAN <br /> RlaNGENOOD I . <br /> NO. TVPE OF FIXTURE OR ITEM FEE ��q HANDLING UNI7- C.F.M. <br /> WATER CLOSET(TOILET) 5 �NCINERATOR I <br /> BATHTUB <br /> �AVATORV lWASH BASIN) I <br /> SHOWER <br /> KITCHEN SINK& DISP. SUO TOTAL 5 � <br /> DISHWASHER PERMIT S <br /> LAUNDRY TRAV TOTAIFEE 5 <br /> I <br /> CLOTHES WHSHER 71{�S PEPMIT BECOMES NUII AND VOID IF WORK OR CONSTRUC- <br /> WATEF HEATER TION AUTHOfi12ED IS NOT COMA,tENCFD WITNIN 120 DAVS, Ofl IF <br /> URINAL CONSTRVCTION OR WOHK IS SUSPENDED O!i ABANOONED FOR A <br /> ORINKING FOUNTAIN �ERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. <br /> FLOOP-SINK OR �RAIN I HEREBY CERTIFV THAT I HAVE REAO ANO E�AMINED THIS AP� <br /> VACUUM BREAKERS PLICATION AND KNOW THE S.4htE TO 6E TRUE AND CORRECT. ALL <br /> ROOF DRAINS-RAINLEADERS � P�OVISIOYS OF LAWS AND ORDINANCES GOVERNING THIS TVPE <br /> OF WORK WILI OE COAIP�IED WITH WIiETHER SPECIPIED HEREIN <br /> SINK fSERVICE-BAR, ETC.1 �- OF NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTHORITV l'O VIOLATE OR CANCEL THE PFOVISIONS OF <br /> ANY OTHEfi STATE OR LOCAL LAIV REGULATING CONSTRUCTION <br /> OR THE PERFORMANCE OF CONSTfiIJCTION. <br /> SUBTOTAL <br /> PERMIT 5 <br /> TOTALFEE S <br /> x <br /> SIGNATUREOFCONTRACTORORAUTH.AGENT DATE <br /> SIOE VARO SETOACK Sl'RFET SET�ACK REAR VARDSET6ACK PLAN CHECK NUMBER PL�1N CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑rEs ❑NO FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GftOUP UOiOs OWELIING ( <br /> SI2E OF 6LDG. NO.OF STORIES MA%.00C. LUAD BUILDING 5 �.GV��1V iG � <br /> PLUM�ING � <br /> FIREZONE OASEMENT • FIfiESPRINKLEFS � <br /> R�VESE� �N� MGCHANICAL I <br /> SPECIAL CONDITIONS: OTHER � <br /> _ � <br /> PENELTV SEC. 3071u) � <br /> TOTAL � � <br /> PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED IIN THIS SPACEI THIS IS YOUR P[RMIT <br /> PYPLICpi10YACCIPI[lJOY. PlAySCN[CKEOBY: APPPOVEq� ISSU(�� <br /> C• { <br /> � a <br />