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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 7599M5 <br />EVERE IT, WASHINOTON <br />99701 <br />OLPT. OF CDMVUVITY BUILDING <br />OEVEICPMF HI <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNER MAIL ADDRESS Zlv PHONE <br />Iry 4i'mk re 202 i A vteEt91 <br />♦•� • .nn�� <br />—76 <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 />10x <br />ccPLUMBING <br />CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />G] <br />ED <br />PERMIT <br />❑ BUILDING ❑ PLUMBING JMECHANICAL <br />CLASS OF WORK <br />xx <br />❑NEW ❑ADDITION ❑ALTERATION L9REPAIR <br />D <br />Z <br />VALUATION OF WORK <br />$ <br />❑DEMOLISH ❑FLNCE ❑SIGN ❑SWIMMING POOL <br />LU <br />°' <br />DESCRIBE WORK <br />1120 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑GAS ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES( <br />LOT' BLOCK —OF <br />NO. <br />TYPE OFEOUIP <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 ':A. <br />FORCED AIR SYSTEMS-B.T.V. M EA. <br />I <br />JOB ADDRESS w? �9yryM9y9y <br />AM9PI�.' �L1/wN6 <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />1 <br />EVAPORATIVE COOLER'i <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />' <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />>IQ8 <br />1 <br />WATER CLOSET (TOILET) <br />BATHTUB <br />$ <br />LAVATORY (WASH BASIN) <br />_-- <br />SHOWER <br />KITCHEN SINK &DISP. <br />_ <br />SUBTOTAL 5 <br />I <br />DISHWASHER <br />LALI ND RY TR AV <br />PERMIT S <br />TOTAL FEE $ <br />J 1 <br />CLOTHES WASHER <br />T141S 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 TI.IS 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 />X of� <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.1 <br />- <br />SUBTOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />8 <br />SIGNATUREOF-CONTRACTORORAUTH.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 />VACANT SITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />BUILDING <br />B <br />I <br />SIZE OF BLOC. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />R EOUIRED <br />[DYES ONO <br />MECHANICAL <br />L�.M <br />i �IVMLd+ <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENELTY <br />SEC. 303 (D) <br />I <br />TOTAL <br />rr <br />7 w <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS YOUR PERMIT <br />APPLICATIONAMn'TEDBY: <br />PLANS CHECKED BY. <br />APPROS EO FOA IS.UANCE BY. <br />L ct <br />