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the Evergreen <br />C11 � uIr <br />everett <br />CITY HALL 159881$ <br />EVERETT. WASHINGTON <br />LINT <br />BER, BF[BN^BwLy; BUILDING <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNER MAIL ADDRESS ZIP PHONE <br />as mam 1731 Hf�b8r1!' <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />itn-% <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL COtJTTRRACT0R MAIL ADDRESS PHONE LICENSE NO. <br />.KAim <br />cc <br />P LUM DING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />LU <br />m <br />co <br />PERMIT CLASS <br />❑ BUILDING ❑ PLUMBING d�!MECHANICAL <br />OF WORK <br />Cl NEW ❑ADDITION ❑ALTERATION AEPAIR <br />Z <br />~ <br />VALUATION OF WORK <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />S <br />W <br />a <br />DESLRIBE WORK �5 <br />i7 <br />1019 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑ GAS ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY )SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK _OF <br />TYPE OF EQUIPMENT <br />iEE <br />UNITS-H. P. EA. <br />ATION UNITS-H.P. EA. <br />1{,P. EA. <br />1 <br />M801LERS-H.P. <br />A.C. UNITS -TONNAGE EA. <br />IR SYSTEMS-B.T.U. M EA. <br />JOB ADDRESS <br />TE RC D.T.U. MERS-B.T.U. <br />M <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT- C.F.M. <br />NO.j <br />YPE OF FIXTURE OR ITEM <br />FEE <br />'— <br />INCINERATOR <br />OSET )TOILE TI <br />S <br />I <br />Y (WASH BASIN) <br />SINK & DI SP. <br />ER <br />LAUNDRY TRAY <br />SUBTOTALIss <br />PERMIT <br />TOTAL FEE <br />1 <br />I <br />CLOTHES WASHER <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 />HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPRIVATION 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 />GI NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE LE CAL LAW' REGULATING CONSTRUCTION <br />OR THE PERFORMANCE O� CONSTRUCTION. <br />x <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLE ADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />S <br />SIGNATURE OF CONTRACTOR OR AUiH.AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARDSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANTSITE <br />❑YES []NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCV PA GROUP <br />WD UNITS DWELLING <br />I <br />BUILDING <br />S <br />1 <br />I <br />SIZE OF SLOG. <br />NO. OF STORIES <br />VAX. OCC. LOAD <br />PLUMBING <br />FIRE 20NE <br />BASEMENT <br />REQUIREIDKLERS <br />[]YES ONO <br />MECHANICAL <br />71C0 <br />I <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />PENELTY <br />SEC. 303(B) <br />. - <br />TOTAL <br />I W <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />0 <br />APPLICATION ACCEPTEUBY', <br />PLANSC14ECKED BY'. <br />A^PROVL) F1 I*OR UANCE BY <br />M <br />