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the Evergreen <br />CITY OF <br />everett <br />LILY HALL }Sy RR05 <br />L VERETI, N'ASHINGTON <br />99101 <br />"`PT OOC E`IOPMCINT BUILDING <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �.e� <br />OWNER MAIL ADDRESS ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO, <br />on i>..>c% 130 <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE IICEr7cF Nam. <br />W <br />m <br />PERMIT <br />M BUILDING ❑ PLUMBING ❑ MECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION REPAIR <br />D <br />Z <br />~ <br />VALUATION aF W2fK <br />>� <br />s <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />cc <br />W <br />a <br />DESCRIBE WORK <br />PA"S�EiAL ' c'i <br />894 <br />PROPOSED USE <br />M♦:CHANICAL <br />TYPEOF FUEL ❑OIL ❑O/AT ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-M.P. EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />GAS FIRED A.C. ON; tS-TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.V. M EA. <br />I <br />JOB ADDRESS �t1w� c�a�t, <br />iF�IA 1*CI,Lc <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />J <br />I <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 />I <br />WATER CLOSET (TOILET) <br />g <br />- <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />_ <br />SHOWER <br />1— <br />KITCHEN SINK & DISP. <br />SUBTOTAL S <br />I <br />DISHWASHER <br />PERMIT 5 <br />LAUNDRY TRAY <br />TOTAL FEE 5 <br />I <br />CLOTHES WASHED <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 OP 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 />�JF� �L/�n�C <br />x �+ <br />WATER HEATER <br />URINAL <br />FOUNTAIN <br />DRINKING FO <br />FLOOR-SINKUN DRAIN <br />VACUUM BREAKERS <br />—� <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />$ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDEYARDSETBACK <br />STREETSETBACK <br />REARYARDSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANTSITE <br />DYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />WOOF DWELLING <br />UNITS <br />I <br />BUI LOINS <br />S W <br />SI M! <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />I <br />FIRE ZONE <br />BASEMENT <br />FITYESPRINKLERSrQUIR <br />RILIVES D <br />(]YES ONO <br />MECHANICAL <br />— <br />I <br />_ <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENELTY <br />SEC. 303 (A) <br />1 <br />TOTAL <br />w <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IIN THIS SPACE) THIS IS YOUR PERMIT <br />Q <br />APPLICATION ACCEPTED BY: <br />PLANB CHECKED BV: <br />APPROVED POP ;"�UANCE BY. <br />