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tlrc Evcrgreen <br /> ��T�oF CONSTRUCTION everett <br /> everett PERMIT <br /> Lltt MdLI }598985 <br /> [VEPEIi.WFSNINGIDN <br /> �etoi <br /> °E°� °°°°°°°�"' BUILDING MECHANICAL PLUMBING <br /> ocvcio^ucxr <br /> OWNER � MAILAODRE55 ZIP PNONE <br /> V. � �.:Nil.l � aXJ r� �� <br /> ARCHIT4:TORDESIGNEfi MAILADDRESS PHONE LIGENSENO. <br /> GENERALCONTRACTOR MA�LADDRESS PHONE LICENSENO. <br /> bC!'� C'Xt:�T'� <br /> MECHANICAL CONTRACTOR MA�L ADDRESS PHONE LICENSE NO. <br /> PLUMBING CONTR4CTOR M/111.ADORE55 PHONE LICENSE NO. � <br /> W <br /> m <br /> PERMIT CLA55 OF WOflK � <br /> Z <br /> �3UILOING [� PLUMBING �MECHANICAL j' H <br /> ❑NEl'1 ❑ADDITION ❑AITERATION 1'�REPAIR � , <br /> VALVATION OF�ORI� <br /> )S,��u ❑DEMOLISH ❑F-ENCE ❑SIGN ❑SWIMMING POOL W <br /> s a <br /> DESCRIBC WORK <br /> r_:���� (c:��) 8 51 <br /> PPOPOSE�USE MECNAN�CAL <br /> LEGAL DESCRIPTION OF PROPEFTV (SHOW BELOW OR ATTACH T�PE OF FUEL �OIL ❑GAS ❑LPG. �ELEC. <br /> FOUR COPI 1 <br /> Lo7 LOCK�oF �'�,� � NO. TYPEOFEQUIPMENT FEE <br /> AIR COND. UNITS-H.P. EA. 5 I <br /> REFFiIGEftATION UNITS-H.P. EA. <br /> BOILGRS-H.P. EA. 1 <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> f-ORCED AIR SVSTEMS-B.T.II. M EA. I <br /> ' J09AD�RESS � N� WALLHEATERS-B.T.V. M ' <br /> ���~ VNIT HEATERS-�.T.U. M 1 <br /> EVAPOqATIVECOOLERS <br /> PLUMBING CLOTHES OFVEFS I <br /> VENTILATION FAN <br /> RANGENOOD I <br /> AIR MANDLING UNIT- C.F.M. � <br /> NO. TVPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSETITOILET) 5 �NCINERl�TOR I <br /> BATHTUB <br /> LAVATORV(W�+SH BASIN) I <br /> SHOWER <br /> KITCHEN SINK& DISP. SUB TOTAL 5 � <br /> OISHWASHEF PERMIT 5 <br /> LAUNORV TFAY TOTAIFEE 5 � <br /> GLOTHES WASHER TNIS PERh11T OEC00.1E5 NULL AND VOID IF WORK OR CONSTRUG � <br /> WATER HEATER TION AVTNORIZED IS NOT COb1A1ENCEO WITHIN 120 DAYS, OP IF <br /> URINAL � CONSTRUCTION OR WOFK IS SUSPENDED OR ABANOONED FOR A <br /> �RINKING FOUNTAIN �- PLFIOD OF 1:0 DAVS !�T ANV TIME AFTER WORK IS COMMENCED. <br /> FLOOR-SINK OR ORAIN I HEREOY CEFTIFV THAT I HAVE RE4D AND E%AMINED THIS AP� <br /> VAGUUM OREAY.ERS I PLICATION AND KNOW THE SAM11E TO BE TRUE/�N�CORRECT. ALl <br /> ROUF DRAINS-iiAIN�EADERS PAOVISIONS OF LAR'S ANO OFOWANCES GOVERN�NG TMIS TYPE <br /> OF WORK N9LL BE COMPLIED YtITH WHETHEH SPECIf-IED HEREIN <br /> SINK ISERVICE-BAR, ETC.) OR NOT, TIiE GRANTING OF A PERMIT OOES NOT PHESUM1IE TO <br /> GIVE f,UTHORITV TO VIOLATE OR CANCEL THE PflOVI510N5 OF <br /> ANY OTHER STATE OR LOCAL LI�VJ REGULATING CONSTRUCTION <br /> OR THC PERFOPMANCE OF CONSTRUCTION. <br /> SUB TOTAL <br /> PERMIT S� <br /> TOTALFE�= 8 �(f�/.A/ <br /> X yy ,v <br /> SIGNATUFEOFCONT(iACTOPOH/1UTN.AGE�1T DATE <br /> SIOE VAFD SETUACK STREET SET[3ACK REAR YARDSETBAC PLAN CNECK NUMOER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> ❑YES ❑No FEES VALUATION FEE <br /> TYPE Of- CONST. OCCUFqryCY GROUP NO.OF OWELLING <br /> UNITS I <br /> 512E OF BLDG. NO.OF STORIES MA%.000. LOAD BJILOING 5 GI� <br /> PLUMDING � <br /> FIRE20NE dASEMENT FIFLSPFINKLERS <br /> fiEOUI(iED I <br /> ❑VES ❑NO MECHA�JICAL I <br /> SPECIAL CUN�ITIONS: OTMER � <br /> I <br /> PENE�TV SEC.30310) � <br /> - TOTAL �j� <br /> PERMIT VALIDATION <br /> WHGN PPCPERLY VALIDATE�(IN TMIS .?ACEI TH1515 YPUR PGNM1IIT <br /> AM'LIC4110NFCf.CPiC�BY' PL�NSCNECKCDOV'. APPHOV[�f0(11551)ANf.EOY. <br /> � C� <br /> .� • <br />