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B <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598145 <br />EVERETT. WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />everett <br />OWNER MAIL ADDRESS PHONE <br />Russell R. Bean 1628 Walnut Avenue <br />ARCHITECT OR D_ESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />_ _ <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />IT1 <br />3 <br />Z <br />C <br />3 <br />00 <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Natural Gas Equipment Co., Inc. 258-2441 <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT <br />❑COMBINATION <br />❑ BUILDING ❑ PLUMBING WECHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑gEPA1R <br />VALUATION OF WORK <br />$ <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S 1 <br />REFRIGERATION UNITS-H.P. EA. <br />�— <br />BOILERS-".P. EA. <br />1 <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />SPACE & WALL HEATERS - B.T.U. <br />JOB ADDRESS <br />1628 Walnut <br />UNIT HEATERS-B.T.U. <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />_ <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />S <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />Ion <br />FAC. BUILT FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />I <br />FLOOR DRAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS <br />KITCHEN SINKS & DISP. <br />I <br />SUB TOTAL S <br />2 I 00 <br />BAR SINKS <br />I <br />PERMIT S <br />ROOF DRAINS - RAIN LEADERS <br />I <br />TOTAL FEE SI <br />1 <br />og <br />SHOWER BATHS <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 OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP. <br />PRIVATION AND KNOW THE SAME TO BE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCESS 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 TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE <br />STATE LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />X Check #8009 9/24/78 <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />I <br />WATER HEATERS - ELECTRIC <br />I <br />_ <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />1 <br />I <br />TOTAL <br />SUBPER <br />5 <br />TOTAL FEE <br />WATER <br />SERVICE SIZE BLDG, SUPPLY <br />SIZE <br />SIGNAI URE 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 />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO. <br />UNITS <br />OF OWELLING <br />I <br />BUILDING <br />$ <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />—t <br />FIRE ZONE <br />BASEMENT F-IRESPRINKLERS <br />RE <br />❑YESED ONO <br />MECHANICAL <br />S I OO <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />I <br />PENALTY <br />SEC. 3031A) <br />TOTAL <br />0 <br />PERMIT VALIDATION + <br />11' -Ii0 <br />WHEN PROPERLY VALIDATED (IN T CC'F, i INS IS YOUR PERMIT" <br />0' �*iR <br />CD <br />fl 11�1� <br />AITHI TIONACCFPIEDXY. <br />PLADSCNECKE)RY. AMROVEDFORInUANCERY <br />ADDRESS FILE <br />41 <br />