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the Evergreen - <br /> =�T� �� CONSTRUCTION everett <br /> everett PERMIT <br /> [IfV IIA�� }59d805 <br /> EVFPELT,IYASNINLLON <br /> 9E301 <br /> °"' °oE�E,o;ME;,; BUILDING MECHANICAL PLUMBING <br /> OWNER MA�LADDRESS Z�p YfiONE <br /> ARCHITECTlpq pESIGNER�T MAIL AD�DR��E55 PMONE ��NO. �� <br /> GENERALCONTRACTOR MAILADORESS PHONE LICENSENO. <br /> MECHANICALCONTRACTOR MAILADDRESS PHONE LICENSENO. <br /> PLUMBING CONTRACTOR M�11L AODRFSS PMONE LICENSE NO. � <br /> �� m <br /> PERMIT CLASSOf WORK � � <br /> � <br /> ❑OUILDING �PLUMBING �MECIiANICAL Z <br /> ❑NEW ❑/�OOITION ❑qLTERATION �EPAIR ~ <br /> VALUATION OF WONK � <br /> 5 ❑DEMOLISH ❑FGNCE ❑SIGN ❑SWIMMING POOL W <br /> OESCR�BE WORK <br /> a ' <br /> i814 <br /> PROPOSED USE <br /> MECHANICAL <br /> LEGAL DESCRIPTION OF PROPERTV ISHOW 9ELOW OR AiTl1CH T�PE OF FUEL �OIL ❑GAS ❑LPG. �EIEC. <br /> FOUR COPIE51 <br /> LOT BLOCK_OF N�• TYPEOFEDUIPMENT FEE <br /> AIR COND.UNITS-H.P. EA. 5 I <br /> fiEFRIGEFATION UNITS-M.P. EA. <br /> ❑OILEFS-II.P. EA. � <br /> GAS FIREO A.C. UNITS-TONNAGE EA. <br /> FORCED AIR SVSTEMS-D.T.U. M EA. � <br /> JOB ADDRESS WALL IiEATERS�-O.T.U. M <br /> � �� VNIT HEIITEFS-9.T.V. M � <br /> PlUM81NG EVAPORATNE COOLERS <br /> CLOTHESDflVERS � <br /> VENTII.ATION FAN <br /> RANGEHOOO � � <br /> N TYPE OF FIXTURE OR ITEM FEE nIR FIANDLING UNIT- C.F.M. <br /> WATER CLOSETITOILET) g �NCINERATOp � <br /> BATHTUB <br /> LAVATORY �WqSH BASINI � <br /> SHOWER - <br /> KITCHEN SINK& DISP. SU�TOTAL 5 <br /> DISHWASHER � <br /> PERMIT 5 <br /> LAUNDRY TRAY � <br /> CLOTHES WASHER TOTALFEE 5 � <br /> WATER HEATER TI115 PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUC: <br /> TION AUiliOR12ED IS NOT COMM1IENCED WITHIN 120 DAYS, Oq IF <br /> UflINAL �— CONSTRUCTION OR WOFK IS SUSPENDED OR ABANDONED FOR A <br /> ORINKING FOUNTAIN PERIOD OF 120 DAYS �T ANY TIME AFTER WORK IS COMMENCED. � <br /> FIOOR-SINK OR DRAIN 1 HEREBV CERTIFV TIiAT Y HA\/E REA� AND EXAMINED THIS AP� <br /> VACUUM BREAKERS PLICATION AND KNOW THE SAM17E TO 6E TRUE AND GO.ipECT. ALL <br /> ROOF DRAINS-RAINLEADEFS PFOVISIONS OF LAWS AND OfiDINANCES GOVERNING THIG TVPF <br /> - OF WORK WILL OE C0�7PLIED WITH 1VHETHER SPECIFiFD HEREIN <br /> SINK IScRVICE-6AR,ETC.) OR NOT, THE GfiANTINf OF A PERMIT DOES NOT PRESU:IE TO <br /> --�-- GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OTHEfl STA'i E OR LOCAL LAW REGULATING CONSTRVCTION <br /> OR THE PERPORMANCE OF CONSTPVCTION. <br /> SUB TOTAL <br /> PERMIT 5 <br /> _ TOTAL FEE 5 <br /> x �� <br /> SIGNATUREOFCONtfiACTOFORAVTH.AGENT DATE <br /> SIDEVAROSETOACK STREETSETBACK REARVARDSETOAC P�qNCHECKNUM6ER PLANCHECKFEE <br /> FEE RECEIPT NO. <br /> VSE ZONE LOT AREA VACANT SITE <br /> ❑YES ❑No FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUV NO.OF OWELLING <br /> UNITS <br /> I <br /> 512E OF BLOG. NO.OF STORIES MAX.00C. LOAO �UILOING $ I <br /> 1 <br /> PLUMOING 71M <br /> FIRE70NE BASEMENT FIFiESPfiIf�KLEF15 W <br /> RC�UIRED — � <br /> ❑YES ❑NO MECMANICAL � <br /> SPEGIAL CONOITIONS: OTHER I <br /> i <br /> PENELTV SEC.3031u1 � <br /> TOTAL "�I� <br /> PERMIT VALIDATION <br /> WHEN PROPEFLV VALIDATLD (IN THIS SPACEI THIS IS VOUFl PERMIT <br /> ���LiC�iiONACCLPTCpOY', FlANSCBELK[UpY APVNOVCDfOhI'.Sl1�NCL0Y <br /> � C� <br /> � <br />