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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598745 <br />EVERETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />evereti�e <br />-------- MAIL AOURLSS ZIP PHONL <br />—fdMwdt,— dC}c A^X- 478 <br />A RCMII EC H DESIGNER -U"A]j (L API P7E "'��— LICENSE NO <br />DON <br />IT! <br />Z <br />C <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO, <br />Self <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />3 <br />W <br />(31 <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />F. m <br />Co <br />PERMIT <br />❑COMBINATION <br />9 BUILDING ❑ PLUMBING ❑ MECHANICAL <br />7i <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />W <br />VALUATION OF WORK I''I <br />$ OV}[ <br />EIEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK - — <br />PROPOSED USE <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT �._ BLOCKR24_OF FVP�rgy��V <br />TYPE OF ENEI.G V <br />❑GAS ❑ELEC. <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />B I <br />REFRIGERATION UNITS-H.P. EA. <br />-�— <br />BOILERS - N.P. EA. <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />1 <br />JOB ADDRESS <br />3417 Rucker Ave. <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT HEATERS-B.T.U. <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />i <br />RANGE HOOD <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- <br />BATH TUBS <br />S <br />- <br />IFEE <br />-�DRINKING <br />CLOTHES WASHER <br />I <br />DISH WASHERS <br />I <br />WATER HEATER <br />FOUNTAINS <br />I <br />FAC. BUILT FIREPLACE & CHI <br />IFLOOR <br />DRAINS <br />DAB. SVSTEM: NO OP OUTLETKITCHEN <br />SINKS & DISP. <br />SUBBAR <br />SINKS <br />PERROOF <br />DRAINS -RAIN LEADERS <br />I <br />TOT <br />1 <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 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 />�� <br />X//0 <br />SIG TURE OF CONTRACTORORAU TIT. AGENT on <br />SERVICE SINKS <br />SUMPS -SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />I - <br />WATER HF ATE RS -ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />_ <br />I <br />SUB TOTAL <br />I <br />PERMIT <br />$ I <br />TOTAL FEE-1 <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SIDE YARD SETBACK <br />STREET SETBACK REAR <br />YAROSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA VACANT <br />SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO.OF <br />UNITS <br />DWELLING <br />7--- <br />SIZE OF BLDG. <br />—ZONE <br />NO. OF STORIES MAX. <br />OCC. LOAD <br />BUILDING <br />$ <br />1 <br />I <br />PLUMBING <br />I <br />"--' <br />1 <br />I <br />FIR <br />BASEMENT FI <br />REQUIRED <br />HE SPRINKLERS <br />OYES ONO <br />MECHANICAL <br />SPECIAL CONDITIONS: <br />OTHER <br />PENALTY <br />SEC. 303011 <br />1 <br />t <br />-- <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN 771WCI <br />1rC k RECpPf0 <br />THANK YOU <br />n <br />APPLICATION ACCIPHU tlY: <br />PLANSDIECXWHY, AWROVMI. r:.uuiil RY <br />I1ga/s <br />