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the Evergreen <br />CITY OF <br />everett <br />CITY HALL AT BUS <br />EVE AtD, roA$HINGTON <br />Ism <br />DEFT, OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />e�lerett <br />PLUMBING <br />OWNER MAIL <br />��������� tt MAIIL ADDRESS ZIP PHONE <br />ism Mall .S M 8 3ra <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Si 0 IB <br />� <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />ED <br />ED <br />2 <br />PERMIT <br />❑ BUILDING ❑ PLUMBING ,p(MECHANICAL <br />CLASS OF WORK <br />tt <br />Cl NEW ❑ADDITION ❑ALTERATION 19REPAIR <br />7 <br />♦_ <br />2 <br />VALUATION OF WORK <br />g <br />Cl DEMOLISH ❑FENCE. ❑SIGN []SWIMMING POOL <br />x <br />ILI <br />- a <br />in�aSllA <br />DESCRIBE WORK �a. Will <br />4 LRYY[a �Y:�PiER <br />1826 <br />v <br />PROPOSED USE <br />MECHANICAL <br />T YPE OF FUEL ❑OIL ❑GAnS. ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF - <br />NO. <br />TYPE OF EQUIPMENT <br />FEE _ <br />AIR COND. UNITS-H.P. EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />_ <br />ROILERS-H.P. EA. <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B. M EA. <br />JOB ADDRESS ` P�,S <br />��a <br />WALL HEA ILRS-B.T.U. <br />UNIT HEATERS-B.T.U. M <br />1 _ _ <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHE<DRYERS <br />"'— <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET (TOILET) <br />g <br />_ <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />INO. <br />KITCHEN SINK & DISP. <br />SUBTOTAL S <br />I <br />DISHWASHER <br />PERM'T S <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 PE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECH'IEU 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 />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUMBREAKERS <br />ROOF GRAINS-RAINLEADERS <br />_ <br />SINK ISERVICE-BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />$ <br />TOTALFEE <br />$ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDEYARDSETBACK <br />STREETEETBACK <br />REAR YARD SE- BACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />DYES ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNi OSF DWELLING <br />1 <br />BUILDING <br />S <br />I <br />I <br />512E OF SLOG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERB <br />RCDUIRED <br />❑YES ❑NO <br />MECHANICAL <br />- <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />I <br />PENELTY <br />SEC. 303 (a) <br />I <br />TOTAL <br />.. <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />APPLICATION ACLEPTE00Y: <br />=-7070 <br />