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the Evergreen <br />CITY OF <br />everett <br />CITY HALL ml USE <br />EVERITT, WASHINGTON <br />NEmI <br />DEPT, OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING <br />OWNER <br />��� MAIL ADDRESS _ (((+jjjZ_jjjIP PHONE <br />b 6114 <br />aE� <br />L5�! 76 <br />A R}�CHiT E®Cf D, ESIGNER ADDRESS NNE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />EL <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LI^ENSE NO. <br />ED <br />ED <br />PERMIT <br />a <br />7S BUILDING ❑ PLUMBING ❑ MECHANICAL <br />CLASS OF WORK <br />❑NEW []ADDITION []ALTERATION l&nrPAIR <br />D <br />Z <br />VALUATION OF WORK <br />[I DEMOLISH ❑FENCE ❑SIGN ❑S'NIMMING POOL <br />lr <br />W <br />G. <br />DESCRIBE WORK <br />£�- <br />J L6 <br />�� E� a� <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FVEL ❑OIL ❑GAS ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES( <br />LOT-- BLOCK —OF <br />_ <br />NO. <br />TYPE OF <br />FEE <br />AIR COND. UNITS-H.P.H.P. EA. EA. <br />$ 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 />1 <br />JOB AWALL <br />DI)RESS2 <br />j(j'� RI'�� <br />HEATERS—B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />AIR HANDLING Lim r— C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET (TOILET) <br />$ <br />BATHTUB <br />LAVATORY (WASH BASINI <br />SHOWER <br />KITCHEN SINK & DISP. <br />'+'UB TOTAL $ <br />I <br />DISHWASHER <br />PERMIT S <br />LAUNDRY TRAY <br />TOTAL FEE $ <br />1 <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 HEAD AND EXAMINED THIS AP - <br />P 1I 1ION 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 0 PERMIT DOES NOT PRESUME TO <br />GIVE AVTHO RITY TO VIOLAT= OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />X <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />_ <br />PERMIT <br />$ <br />TOTALFEE <br />$ <br />_ <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 BE'EIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YFS Cl NO <br />FEES <br />VALUATION <br />FEE <br />TYPE BF CONST. <br />O:CUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />BUILDING <br />5 M�+� <br />5 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE LONE <br />BAS MENT <br />FIRESPRINKLERS <br />REQUIRED <br />❑YES ❑NO <br />MECHANICAL <br />1 <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />1 <br />PENELTY <br />SEC. 303 Ia1 <br />I <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THI SBPACEI T III'; IS YOUR PERMIT <br />e <br />APPLICATION ACCEPTED BY <br />I'LANSCHECKEDDY- <br />APPROVED FOR ISSUANCE BYTru <br />