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thc Everg�eeir <br /> ��T,. oF CONSTRUCTION everett <br /> everett PERMIT <br /> CIIV NALI }S9B8P5 <br /> EVEPCii,15'?LIINGiON <br /> 991m <br /> �EVi.00EVELOPMENi BUILDING MECHANICAL PLUMBING <br /> OWNER MAIL ADORESS <br /> ,.y���. ZIP PHDNE <br /> tis.ti..:.� yy� <br /> �i�....( .c�i .i�'�n) iV� !rd�.�.i:L "7:T� <br /> ARCHITECT OR DESIGNEfl MAIL A�DfiE55 PHONE <br /> LICENSE NO. <br /> GENERAL CONTqACTOR MAIL AOORE.^.S PHONE <br /> LICENSE NO. <br /> MECHANICALCONTRACTOF MAILADDRESS PHONE <br /> LICENSE NO. <br /> -, .. <br /> PLUMBING CONTRACTOfi MAIL ADDRE55 <br /> PHONE LICENSE NO. W <br /> m <br /> PEFiM1T CLA55OF WORk � <br /> � <br /> ❑OUILDING �PLUMBING (�htECHANICAL Z � <br /> ' ❑NEW ❑qDDITION ❑ALTEqATION �REPAIq F- <br /> VALUATION OF WORK � . <br /> 5 ❑DEMOL�SH ❑f-ENCE ❑SIGN ❑SWIMMING POOL W <br /> DESCR�BE WORK 1 <br /> .v+. �O 0 <br /> _.t. ;�^ai'r. <br /> PROPOSEO USE <br /> MECHANICAL <br /> LEGAL OESCRIPTION OF PROPERTV ISHOW pELOW OR ATTACH TYPE OF fUEL OOIL ❑GAS ❑LPG. �EI.EC. <br /> FOV R COPIE51 <br /> LOT aLOCK_oF N�• TVPE OF EUUIPMENT FEE <br /> AIR COND. UNITS-II.P. EA. $ I <br /> REf-qIGERATION UNITS-H.P. EA. <br /> pO1LER5-�H.4. EA. � <br /> GI�S FIRED A.C. UNITS-TONNAGE EA. 1— -�- , <br /> f-ORCED AIR SVSTEMS-6.T.U. M FA. � <br /> JOD ADDftESS — I <br /> r�.y� .tr� WALLHEATERS-R.T.U. M � <br /> (� rvh7i�va VNIT HEATERS-O.T.U. M <br /> I <br /> PLUMBING EVAPORA'f I V E COOLERS <br /> __ CLOTHESDRVERS � <br /> V[NTILATION FqN <br /> RANGENOOD '� <br /> i <br /> NO. TVPE OF FIXTURE OR ITEM FEE Allt NANDUNG VNIT- QF.M. ' <br /> WATER CLOSET ITOI�ETI 5 INCINEqATOH � <br /> �ATHTUB - • r � � <br /> I <br /> LAVATOPY�WASN6ASIN) <br /> SHOWEP _ I <br /> KITCHENSINK & DISP. SV6TOTAL 5—�--�-- <br /> OISHWASHER� <br /> LAUNDRY TqAV PERM1IIT 5 <br /> CLOTMFS WASIIEF TOTAL FEE S <br /> WATER IiEATER THIS PERMIT gECOMES NULL AND VOIO IF WORK Oli CONSTRUG <br /> TION AUTIiOfiIZEO IS NOT COMMENCED WITHIN 120 DAYJ, OR IF <br /> URINAL CONSTRUCTION UR WORK IS SUSPENDED OR AyqNDONED FOR A <br /> DRINKING FOUNTAIN PLRIpD OF 120 DAVy qT ANY TIA1H AfTGR WOqR IS CUMMENCED. <br /> _ FLOOF-SINK OR ORqIN I HERE[iV CERTIFY THAT I HAVE REAO AND E%AMINED THIS AP- <br /> VACUUM OREAKFRS PLICATION AND KNOW TN[S4ME TO f3E TRUE AND CORRECT. ALL <br /> ROOF ORAWS-HAIN�EAOERS PROVISIONS Of- LAWS AN� OR�INANCES GOVERNING THIS TVP[ <br /> SINK (SERVICE-AAR, ETC.I OF WORK WILI BE CO�IPLIED WITIi WHETHER SPECIFIED HEREIN <br /> OR NOT, THE GfiANTING OF A PlHM1T DOES NOT PqESUME TO <br /> GNE AVTHORITV TO VIOL4TE OR CANCEL THE PqOVISIONS OF <br /> ANY O14[R STATF OR LOC4L LAW REGULATING CONSTRUCTION <br /> SU� TOTAL <br /> OR THE PFPFpRMAryCE OF CONSTRUCTION. <br /> PERMIT § <br /> TOTALFEE $ <br /> x r, <br /> SIGNATUREOFCONTRACTOf.OFAUTH.AGENT DATE <br /> SIUE VAqD SET�ACK STREET SET�ArK REFR VAROSETOACK P�qN CIIECK NUMFIER <br /> PLAN CHECK FEE <br /> FEE RECEIPTNO. <br /> USE ZONE LOT AFF.A VACANTSITE <br /> ❑vE5 ❑NO FEES VALUATION fEE <br /> TVPE OF CONSi. OCCUPANCV qRpUP NO.OF UWELLING - <br /> UNIT$ <br /> 1 <br /> SIZE OF �LDG. NO,OF STOqIES MA%.00C. LOAO �UIL�ING 5 I <br /> I <br /> PIFE20NE �ASEMENT FIqESPRINKLEiiS PLUMBING � <br /> RfQU1RED <br /> ❑VES ❑NO MECHANICAL � <br /> SPECIAL CON�ITIONS: <br /> OTHER � <br /> I <br /> PENELTV SEC.3031a) � <br /> TOTAL � � <br /> —_ _._ _ � � <br /> I PERMIT VALIDqT10N <br /> WHEN PRCPFRI.Y VALIDATGD(IN THIS SPACEI THIS IS \'OUR PENMIT <br /> �O�LiCAiiONACC�PilDOY� FLAfISCqELKEUqY. qPPqOVEOPo(iISSIIMCE�Y <br /> � C.♦ <br /> � <br /> t <br />