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the Evergreen <br />CITY OF <br />eve rett <br />CITY 1/ALL 259 8745 <br />EVER ETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />OWNER MAIL ADDRESS LP PHONL <br />Bobby Ray Snyder 3606 Rucker <br />7) <br />rD <br />- <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Z <br />C <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Natural Gas Equipment <br />m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT <br />CLASS OF WORK <br />-� <br />❑COMBINATION <br />❑ BUILDING ❑ PLUMBING alMECHANICAL <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />S <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 />NO. <br />1 TYPE OF EOUIPMENT <br />FEE <br />LOT BLOCK —OF <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />- <br />BOILERS-H.P. EA. <br />I <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />I <br />JOB ADDRESS <br />_ <br />SPACE IN WALL HEATERS - B.T.U. <br />3606 Rucker <br />UNIT HEATERS-B.T.U. <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M <br />BATH TUBS <br />$ <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />fts <br />DISH WASHERSDRINKING <br />FOUNTAINS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEFLOOR <br />DRAINS <br />I <br />_ <br />GAS. SYSTEM: NO OP OUTLETS <br />KITCHEN SINKS & DISP. <br />I <br />SUBTOTBAR <br />SINKS <br />PERMIT <br />ROOF DRAINS - RAIN LEADERS <br />I <br />TOTAL FEE $ <br />I <br />SHOWER BATHS <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR NS C <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IB 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 />X (� , • ,� �..-�- 3/3 78 <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />WATER HEATERS - ELECTRIC <br />I <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />1 <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />SI <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />SIGNATUREOFCON. RAC D, ORAurH. AGENT DATE <br />SIDE YARD SETBACK <br />STRFET SETBACK <br />HEAR YAROSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />rYPE OF CONST. <br />OCCUPANCY GROUP NO. <br />OS DWELLING <br />UNITI <br />BUILDING <br />$ <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT FI <br />RESPRINKLERS <br />MECHANICAL <br />OTHER <br />5 I OO <br />R <br />EOUISED <br />OYES[]NO <br />SPECIAL CONDITIONS: <br />_ <br />I <br />PENALTY <br />SEC. 3031a1 <br />I <br />- <br />TOTAL <br />SI 00 <br />-- _ <br />PERMIT VALIDATION <br />- -- -- <br />WHEN PROPS RLY VAL IDATLD IiN 1ni5'PACE _ M SISYQURPERMIT, <br />- <br />7573 <br />--- <br />1001A RE &iPT� <br />` ' THANK <br />A"LICALIONACCBPLLBBY <br />PLANS Offl:KLOBY. AwnovLOrOBISSUANCfBY <br />eb <br />YOU. <br />(1 <br />ADDRESS FILE <br />