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the Evergreen ' <br />L.uNb I KULMON <br />everett <br />evereri <br />PERMIT <br />C11Y HALL 9599HS <br />EVERETT, WASHINGTON <br />SIMI <br />°`" °C O"LIPMENT BUILDING <br />MECHANICAL PLUMBING <br />owrvE R <br />�J ♦K9 AAL.LR .A.IDE �DgEss ZIP PHONE <br />A RCMITE CT OR DESIGNER <br />- MAIL ADDRESS <br />PHONE LICENSE NO. C.Vw77 <br />G ENERAL CONTRACTOR <br />MAIL ADDRESS <br />aif <br />PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR <br />MgIL ADDRESS <br />PHONE LICENSE NO. <br />PLUMBING CONTRACTOR <br />oSAIL ADDRESS <br />PHONE LICENSE NO. <br />cr <br />W <br />PERMIT <br />CLASS OF WORK <br />BUILDING El PLUMBING ❑MECHANICAL <br />D <br />Z <br />❑NEW ❑ADDITION ❑ALTERATION [REPAIR <br />= <br />VALUATION OF WORK <br />S Zl <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />W <br />CL <br />PROPOSED USE , <br />//� e <br />2440 <br />MECHANICAL <br />TYPE Of FUEL ❑OIL ❑CAS, ❑LPG. ❑ELEC. <br />I OUR c PIES)LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />LOT 11 <br />BLOCK JL OF ('�9�nt. <br />JIfJ <br />.Wl n <br />NO. <br />- <br />TYPE OF EOUIPMEN7 FEE <br />AIR COND. UNITS-H.P, EA. $ <br />REFRIGERATION UNITS-M.P. EA. <br />BOILERS-H.P. EA, <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />JOB ADDRESS <br />FORCED AIR SYSTEMS-B.T.U. M EA. I <br />E �iV� xzla <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT- C.F.M. <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />_ WATER CLOSET (TOILET) <br />$ <br />INCINERATOR <br />BATHTUB <br />I <br />LAVATORY (WASH BASIN) <br />SHOWER <br />I <br />KITCHEN SINK & DISP. <br />DISHWASHER <br />SUBTOTAL S <br />LAUNDRY TRAY <br />PERMIT S <br />CLOTHES WASHER <br />TOTAL FEE $ <br />WATER HEATER <br />URINAL <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONST RUC <br />TION AUTHORIZED IS <br />DRINKING FOUNTAIN <br />CONSTRUCTION OR WORK IS SUSPENDED ED OIR`iABANDONED IN 120 DAYS -FORIA <br />PERIOD OF 120 DAYS AT ANY TIME <br />FLODA-SINK OR DRAIN <br />AFTER WORK IS COMMENCED. <br />VACUUM BREAKERS <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO <br />ROOF DRAINS -RAIN LEADERS <br />BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES <br />SINK (SERVICE -BAR, ETC.) <br />GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT <br />DOES NOT PRESUME GIVE AUTHORITY TL' VIOLATE OR TO <br />CANCEL THE PROVISIONS OF <br />ANY OTHEAST ATE OR LOCAL LAW REGULATING <br />SUBTOTAL <br />CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />PERMIT <br />g <br />TOTAL FEE <br />S ,�% <br />x .1 /c..� JCICh�Gc <br />SIDE YARD SETBACK STREETSETBACK <br />SIGN- TURF OF CONTRACTOR OR A UTH. ENT DATE <br />REAR YARD SETBAC PLAN <br />CHECK NUMBER AN CHECK FEE <br />USE ZONE TOT AREA <br />FEE RECEIPT NO. <br />VACANTSITE <br />TYPE OF CO HST. OCCUPANCY GROUP <br />❑vE5 ONO FEES VALUATION FEE <br />NO. OF DWELLING <br />UNITS <br />512E OF BLDG. NO. OF STORIES <br />1 <br />MA%. OCC. LOAD BUILDING $ 1 <br />I <br />ARE ZONE BASEMENT <br />FIRESPRINKLERS PLUMBING 1 <br />REQUIRED <br />OYES ONO MECHANICAL <br />SPECIAL CONDITIONS: <br />1 <br />OTHER 1 <br />I <br />PENELTY SEC. J03 (A) 1 <br />TOTAL I <br />1 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERM <br />AWLICATION ACCEPTED IT: PLANSCNECKED BY: <br />APPROVE "� tI ISSUANCE BY. <br />n <br />