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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 1511IMS <br />EVERETT. WASHINGTON <br />M2OI <br />BELT_ BC COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT" <br />MECHANICAL <br />everett <br />P-UMBING �.e <br />OWNER MAIL ADDRESS ZIP PHONE <br />GDorge D. Hoppe 3803 Cascadia Av.). 3c2(11: 317-3737 <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 />cr <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />EU <br />W <br />m <br />PERMIT <br />❑ BUILDING ❑ PLUMBING [)MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION VREPAIq <br />� <br />Z <br />h <br />VALUATION OF WORK <br />$ of) on <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />cc <br />1 <br />DESCRIBE WORK <br />Re -roof composition <br />1143 <br />PROPOSED USE <br />MECHANICAL <br />TYPE Of FUEL ❑OIL ❑GAS ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOU12'W ) 44.2 Captial ]fill Add. <br />L <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 />1 <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />—�— _ <br />FORCED AIR SYSTEMS—B.T.U. M EA. <br />1 <br />!� <br />'4�01.`f RWrginin Avenue <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />1 <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />1 <br />WATER CLOSET (TOILET) <br />$ <br />BATHTUB <br />LAVATORY (WASH B_w.41 - <br />I <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUBTOTAL $ <br />1 <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 720 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORT( IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE IWAD AND EXAMINED THIS AP - <br />FLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDfNANCES GOVERNING THIS TYPE <br />OF :PORK 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 1 nr.AL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />7/27/76 <br />x <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />_ <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-R AINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />I <br />SUB TOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />$ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARDSETBACK <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 />OCCUPAR,.V GROUP <br />NO.OF DWELLING <br />UNITS <br />1 <br />BUILDING <br />$ <br />6 00 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX.00C. LOAD <br />PLUMBING <br />) <br />FINE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />OYES ONO <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENELTY <br />SEC. 303 (N) <br />I <br />TOTAL <br />I <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS SPACEI THIS IS YOUR PERMIT <br />0 <br />APPLICATION ACCEPTED By <br />L.C. <br />PLAO;CNECKEDfPY <br />APPROVED FOR 6WANCE BY. <br />L.C. <br />