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the Evergreen <br /> =�TYaF CONSTRUCTION everett <br /> everett PERMIT <br /> utt xau isseses <br /> cvcxnr,ciaswxmox <br /> seim <br /> °'�, ,'° °°^'M°�°° BUILDING MECHANICAL PLUMBING <br /> o[veiovrntx� <br /> OWNEfi �r�p MAI�ADDRE55 ZIP {'MONE <br /> ���� l�i..�T� l..it: �'i1T�'i',M'� <br /> ARChI1TECTOflDESIGNER MAILAD�RESS PHONE LICENSENO. <br /> 7.25Ci1�� <br /> GENERAL CONTRACTOR MAII.ADORE55 PHONE LICENSE NO. <br /> MECHANICAL CONTRACTOR MAI�ADDNE55 PHONE LICENSE NO. <br /> � 4 � <br /> P�UMBINGCONTRACTOR MAILADDR[SS PHONI: LICENSENO. � <br /> W <br /> m <br /> PERMIT CLASSOFWORK � ' <br /> Z <br /> ❑UUILDING nPWMBING [�MECHANICAL S F- <br /> ❑NEW ❑ADDITION ❑ALTEflATION L'TREPAIR � <br /> VALUATION OF WORK � <br /> 5 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br /> DESCRI�E WORK �I / O <br /> PROFOSED VSE MECHANICAL <br /> TVPEOFFUEL �OIL �NAT. �LPG. �ELEC. <br /> LEGAL DESCRIPTION OF PROPERTV ISIIqW 6ELOlV OR ATTACH GAS <br /> FOUR COPIES) <br /> LO7 ULOCK—OF NO. TVPE OF EQUIPMENT FEE <br /> AIR COND. VMTS—H.P. EA. S I <br /> REFFIGERATION UNITS—M.P. EA. <br /> �OILERS-HP. [A. I <br /> GAS FIRED A.C.UNITS-TONNAGE EA. � <br /> POFCED Alq SVSTEMS-6.T.U. M EA. I <br /> JOB ADDRESS �l�� WALL HEATERS-6.T.U. M <br /> UNIT H[AT[RS-�.T.U. M � <br /> PLUMBING EVAPORATIVE COOLERS � <br /> CLOTHESOPVERS � <br /> VENTILATION FAN <br /> RANGEHOOO I <br /> NO. NPE OF FIXTURE OR ITEM FEE AIF HANDLING UNIT- C.F.M. <br /> WATEP CLOSETITOILETI g INCINE A OR � <br /> �ATHTUB <br /> LAVATORYIWASMBASIN) I <br /> SHOWER <br /> KITCHEN SINK& �ISP. SUB TOTAL 5 <br /> DISHI4ASHER _}_ PERMIT 5 <br /> LAUNDRVTRAV TOTALFEE 5 <br /> CL >THES WASMER THIS PEFMIT �FC�MES NULL ANO VOI� IF WORK OR CONSTRUC� <br /> WATEF HEATER TION AUTHORIZ[D IS NOT rOMM1fENCED WITHIN 120 DAVS, OR IF <br /> URItJAL GUN51 HUC110N OR WORK IS SUSPENOEO OR ABANDONED FOR n <br /> DRWKING FOUNTAIN PERIOO OF 120 DAVS AT AN'/ TIM[ AFTEF WORK IS COMMENCED. <br /> F�OOR-SINK Ofl DqA1N I HEREBV CERTIFV TNAT 1 I1AVE READ AND E%AMINED THIS AP� <br /> VACUUM BREAKERS PLIC/1TION AND KNOW THE 5l�ME TO�E TRUF qND CORPECT. ALL <br /> ROOF ORAINS-RNNLEADEFiS --�— P�OVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPL <br /> OF WORK WILL �E COMPLIFD WITH WHETHER SPECIFIED HEREIN <br /> SINK (SERVICE-BAR, ETC.) OR NOT, TIiE GRl�NTING uf A rEFA11T DOES NO'f PRESUME LO <br /> GIVE AUTHORII'Y TO VIOIA?�. UN CANCEL THE PROVISIONS OF <br /> ANY pTHER STAiE OR LOC4L LAW flEGULMING CONSTRUC'�ION <br /> OR THE PEFiPOHMANCE OF CONSTRUCTION. <br /> SUBTOTAL <br /> PERMIT S <br /> TOTALFEE 5 i <br /> X �� <br /> SIGNATVFEOFCONTfll.GTOROftAUTH.AGENT DATE <br /> SI�E YARO SETOACK STREET SETOACK REAq VARDSETFAC PIAN CNECK NUMUER PLAN CHECK FEE <br /> FEE IiECEIPT NO. <br /> USEZONE lOTAREA VACANTSITE <br /> ❑YES [INo FEES VALUATION FEE <br /> TYPEOFWNST. OCCUPANCYGFOUP NO.OFOWELLING <br /> UNITS I <br /> SIZE OF ULDG. NO.OF STORIES MAX. OCC. LOAD B�:ILDING $ � <br /> I <br /> PLUM6ING � <br /> 1"Ifi[ 20NC DASEMENT FIRESPPINKLERS ' <br /> Rf!]UIFED �� <br /> ❑VES ❑NO MECHANICAL �� <br /> SPECIAL CONDITIONS: OTNER � <br /> PENELTY SEC. 30710) I <br /> TOTAI 1 � <br /> PERMIT V ALIDATION <br /> WHEN PROP@RLV VA�IDATED IIN THIS SPACEI THIS IS VOUR PERMIT <br /> pPPIICATiONPCC(Pi[UOY. PLANSLN(CKEOOY. AFPqpyEDjORICU•ANC(BY�. <br /> S� <br /> 3 <br />