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the Evergreen <br />CITY of <br />everett <br />CITYNALL 20BUS <br />EVERE". IWKNINGTON <br />BBNI <br />OEM, OF LONYUNITY BUILDING <br />OEVEIOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING ,e <br />OWNER MAIL ADDRESS ZIP PHONE <br />navi:i H. Buckley 2120 Virginia 99201 252-2M; <br />7;1-77 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />LU <br />D7 <br />PERMIT <br />BUILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑NEW UADDITION ❑ALTERATION ❑REPAIR <br />Cf <br />Z <br />~ <br />VALUATION OF WORK <br />$ 3P900.00 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />Er <br />W <br />a <br />DESCRIBE WORK <br />22' 24 ^. 4' addition <br />2755 <br />PROPOSED USE <br />Pardly room <br />MECHANICAL <br />LEGAL DESCRIPTION OF PRONE RT`. ISNOW OE LOW OR ATTACH <br />-OUR CaR1ES�o 442 Capitol hill MEALtion <br />LOT 1177 BLOCK —OF <br />TYPEOFFUEL []OIL ❑NAT.❑LPG. ❑ELEC. <br />GAS <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />COND. UNITS-H.P. EA. <br />S 1 <br />REFRIGERATION UNITS-H.P. EA. <br />— <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 />I <br />pp E, <br />.loB l EPvirainia <br />L <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) <br />$ <br />INCINERATOR <br />I <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />K, CHENSINK&DISP. <br />SUBTOTAL $ <br />1 <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTAL FEE S <br />) <br />CLOTHES WASHER <br />WATER HEATER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />I TION PUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OP 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 THIS 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 />6/21/77 <br />x <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 />PERMIT <br />$ <br />TOTAL FEE <br />$ 1 <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SE JEIACK <br />STREET SETjACTK <br />ll�� <br />REAR YAR�SETB ACK <br />LL <br />PLAN CHECK NUMBER <br />77/406 <br />PLAN CHECK FEE <br />FEE 14. on RECE1PZ *4.' <br />USE ZONlliiE.Y i <br />LOT AREA <br />VACANT SITE ,X <br />OYES NO <br />FEES <br />VALUATION <br />FEE <br />TYPEffft ft <br />i�LEEL�i <br />OCCUPANCY GROUP <br />NO. OFDWELLING <br />UNITS <br />I <br />SIZE 424LxD14, (a(I <br />L <br />O.IF $ST], DRIES <br />MAX. OCC. LOAD <br />BUILDING <br />$ MID. <br />' <br />PLUMBING <br />I <br />FIRE ZONE <br />3 <br />BASEMENT <br />no <br />FIRESPRINKLERS <br />REQUIRED F <br />DYES NO <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />— <br />PENELTY <br />SEC. 303 (a) <br />TOTAL <br />I <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />s <br />AALIUTIDN A[L[PTEO BY: <br />PLANS LBECKED BY APPROVED <br />FOB IMUANCE BY. <br />L.C. <br />