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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 25983115 <br />EVERETI, WASHINGTON <br />91101 <br />DER. Of <br />DEVELOPMENT BUILDING <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNI It MAIL ADDRESS ZIP PHONE <br />3l' __'5 31 ol t;S '`A'?-Xn Avg. 355muz <br />'MII.76 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />G NERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cc <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />O] <br />PERMIT <br />,y <br />[5BUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW ThADDITION ❑ALTERATION ❑REPAIR <br />� <br />z <br />H <br />VALUATION.PLW2&K <br />IS <br />❑DEMOLISH &FENCE ❑SIGN ❑SWIMMING POOL <br />LU <br />G <br />DESCRIBE WORK iyvani ..� <br />A:?S�4' dlXt7 I{* ]FI-'fl(?` ZG'r :115tiV ?df'32 AM am P � <br />C (712 <br />L <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑GA6. ❑LPG. ❑FLEE. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR�OPIE51 6 ,:mw. <br />LOT BLOCK —OF— <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS—H.P. EA. <br />S I <br />REFRIGERATION UNITS—H.P. EA. <br />BOILERS—H.P. EA. <br />I <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />FORCED AIR SYSTEMS—B.T.U. M EA. <br />I <br />JOB ADDOLSS Atli <br />r <br />WALL HEATERS—O.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATORBATHTUB <br />WATER CLOSET(TOILET) <br />$ <br />[NO::: <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUBTOTAL $ <br />I <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTAL FEE $ <br />I <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />\YATER NEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADE RS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />5 <br />TOTALFEE <br />S <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />BUILDING <br />yyyy�� /y <br />5 3W*00 <br />yY� <br />Mr <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. BCC. LOAD <br />-SPRINKLERS <br />PLUMBING <br />FIRE ZONE <br />BASEMEN'. <br />RrQUI <br />RfO <br />ONO ES <br />OYES <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS' <br />OTHER <br />I <br />PENELTY <br />SEC. 3031BI <br />I <br />TOTAL <br />5 I"o <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />A,TLICA71011 ACCEPTED BY <br />PLANS CHECKED BY: <br />APPROYCOI A MIJANCE by <br />�.cy <br />