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thc Cac�grcen <br /> �,r�oF CONSTRUCTIVi� everett <br /> everett PERMIT <br /> [IIY�41L 159 PflE• <br /> CVfNfil.W45NING10'I <br /> 96i41 <br /> °�°T °f°°M^,°��'° gUILDING MECHANICAL PLUMBING <br /> o�vu avMr ni <br /> OWNER MAIL AD�RESS ZIP PHONE <br /> P�p! TSLT �r..'?''�. ^.,c�ar 259-uTri, <br /> AqCHITECT OR DESIGNEF MAIL ALDRE55 PHONE L ICENSE NO. ��� <br /> GENERAL COKTRACTOF MAIL ADDRE55 PHONE LIC[NSE NO. <br /> ��r T3:.f.�Cf91�E ��J �'76�.'j�'4L^1 1b0� ��"�'t`:`'""'.''�. �+�'?Q <br /> MECHANICAL CONTqACTOIi MAIL ADDRE55 PHONE LICENSE NO. <br /> PLUMOING CONTHACTOR MAIL ADDRESS �HONE LICENSE NO. W <br /> m <br /> PERMIT CLASSOF WOqK � <br /> }, Z <br /> �J BUILDING � PLUM9ING �MECHANICAL F <br /> ❑NEW ❑l+ODITION ❑ALTERIITION ❑REPAIR � <br /> VALUATION OF WORK � <br /> S �M ❑�EMOUSH ❑FENCE ❑SIGN ❑SWIMMING POOL a ' <br /> W <br /> DESCHIB�RK �A^� <br /> o���y �� <br /> PROPOSEO USE MECHANICAL <br /> �EGA�DESCRiPT10N OF VROPEPTV ISHOW p[I.OW OIi ATTACH TVPE OF FU[L �OIL ❑GAS ❑LPG. �ELEC. <br /> Fou�p�liisl � y�C �� n NO. 7VPE OF E�UIPMEN7 FEE <br /> ii14G <br /> lOT 6LOCK_Of- ' <br /> NR CONO.UNITS-N.P. FA. 5 I <br /> _ fiEFRIGERATION UNITS-H.P. EA. I <br /> AOILGRS-11.1+. EA. 1 <br /> GAS FIqEO A.C'UNi f5-TONNAGE El�. <br /> FOFCEO AIR SVSTGA'S--O.T.U. M En. I <br /> JUD ADDRES$ WALL HEATEIiS-B.T.U. M <br /> � n� VNIT HEAT[RS-�.T.U. M � <br /> EVl�POfiATIVE COOL[RS . <br /> PLUMBING ICLOTNESDRVEFS I <br /> VENTILATION FAN <br /> RANGEMOOD I <br /> NO. TVPE OF FIXTURE OR ITEM FEE nIR HANDLING VNIT— QF.M. <br /> WATER CLOSET(TORETI 5 INCWERnTOR I <br /> BATNTUB <br /> LAVATORV IWASN�ASIN) I <br /> SHOWER <br /> KITCIIEN SINK& OISP. SUO TOTAL 5 I <br /> DISHWASHEfl PEfiMIT 5 <br /> LAUNDRV TFAY TOTAL FEE S I <br /> CLOTHES WASHER Try15 PEPMIT �ECOMES NULL AND VOID IF WORK Ofi CONSTRUC� <br /> WATER HEATER TION AUTHORIZ@D IS NOT COMMCNCED WITHIY 120 DAVS, OR IF <br /> UFINAL CONSTRUCTION OR WORK IS .;USPENOED OR A6AN�ONED FOR A <br /> DRINY.ING fOUNTAIN PEFIOD OF 120 OAVS AT ANV i IME APTER WOPK IS COMMENCED. <br /> FLOOR-SINK OR DFAIN � iiFREHV CEFtIFV THAT I HAV[ REAO A�'O G%AMIhEU TMIS AP- <br /> VACUUM OFENKEfiS PLICATION AND KNOW iME SAME TO(3E iqUE AND CORRECL ALL <br /> PROVISIONS OF LAWS AN� ORDINANC[5 GOVEfiNING -fNIS TVPE <br /> qOOF ORAINS-PAINLEApERS OF WORK WILL �E COMPLIED WITH WHETHER SPECIFIEO HEFEIN <br /> SINK (SERVICE-DAR, ETC.) t OR NOT, THE GRl�NTING OF A PEPMIT pOES NOT P9ESUME TO <br /> — GNE AUTHORITV TO VIOLATE Ofi CI�NCEI THE PROVISIONS OF <br /> ANY OTHEIi STATE OR LOCAL LAW REGVI�TING CONSTRUCTION <br /> ON TNE PEHFORMANCE OF CONSTqUCTION. <br /> SUBTOTAL <br /> PEIiMIT ¢ r— <br /> TOTALFEE _ $ _ �� <br /> x <br /> SIGN/�TUREOI'CONiRACTONOFAUTH.AGENT �ATE <br /> SIDE VA305ETUACK STREET SET9FCK HEAR VARDSET6l1C PL�N CMECK NUN6Gq PLAN CHECK fEE <br /> FEE IiEC[IPT NO. <br /> USE 20NE LOT �1REP VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TVP[ OF CONST. OCCUPANCY G�OUP VNiOs OWELLING I <br /> SILE OF PLDG. NO.OF STORIES MAX.00C. LOAD ❑UILDING 5 Uy:'��WJ � �W� <br /> PLUMOING � <br /> FIRE 2UNE DASEMENT FIRE PRINKLERS <br /> FEDVIRED � <br /> ❑vE3 ❑NO MECHANICAL I <br /> SPFCIALCONOITIONS�. OTMER � <br /> _ __—_ I <br /> __ .__ PFNELi'Y SEC.9071a) � <br /> — — TOTAL �j � <br /> PERMIT VALIDATION <br /> WHEN PROPEfiLY VALiOATEO (IN THISSP/10E)TMIS IS YOUR V[RMIT <br /> AM'LICATION PRIPlflln\' �'I�tiS(Lf.CCffIP.V � ACPYUVEO(ONISSUPNCCOV <br /> !'�I <br /> Q <br />