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the Evergreen <br />CITY OF CONSTRUCTION <br />everett PERMIT <br />BUILDING MECHANICAL <br />111 •iIIIIONIyI <br />c%I -rcltl <br />PLUMBING �,e� <br />OWNER MAIL ADDRESS <br />140 row 74moodsodlm I = PAate <br />ARCHIT ECTORDESIGNER MAIL ADDRESS <br />4;8& rim a a. _ 2? lodabOw <br />GENERAL CU/N�T RACTO.� �RyyMAAIIL / <br />ADDRESS <br />zoo <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />PERMIT CLASS OF WORK <br />11BVILOING ❑PLUMBING ❑MECHANICAL <br />❑NEW <br />JIIPH.�^,! <br />984e01 <br />vHONf Lt—C�NSEh <br />252 M <br />61,))N'fl` UII <br />CFNSE N <br />,�F� <br />PHONE LICENSE N(I <br />PHONE LICENSE N' <br />❑ADDITION ❑ALTERATION ❑REPAIR <br />353-77 <br />W <br />m <br />Z <br />H <br />BE <br />VALUATION OF WORK <br />❑ DEMOLISH <br />s <br />DESCRIBE WORK <br />c = 1e .es"imit to +~.tee dw <br />❑FENCE. ❑SIGN ❑SWIMMING POOL <br />BE <br />2 <br />21 SG <br />PROPOSED USE <br />MECHANICAL <br />TV�OF IVEL ❑UIL ❑GAS ❑LP(y �ELEC. <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW <br />FOUR COPIESI <br />LOT BLOCK —OF - - <br />_ <br />JOB ADDRESS <br />OR ATTACH <br />NO. <br />TYPE OF E_OUIPMENT <br />FEE <br />MR COND. UNITS- H.P. EA_ <br />El I <br />REFRIGERATION UNITS -HP. EA <br />r— <br />BOILERS H.P. EA. <br />1 <br />GAS FIRED A.C. UNITS _-TONNAGE EA <br />�— <br />FORCED AIR SYSTEMS BTU. M EA <br />1 <br />WALL HEATERS-B. TV M <br />UNIT HEATERS-B L,U. M <br />1 <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGE HOOD <br />1 <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET ITOII.ETI <br />s <br />INCINERATOR <br />I <br />BATHTUB <br />LAVATORY(WASH BASINI <br />I <br />SHOWER <br />KITCHEN SINK d DISP. <br />- <br />6VB TGTwI <br />1 <br />DISHWASHER <br />LAUNDRY TRAY <br />{ <br />PERMIT S <br />TOTAL FEE S <br />1 <br />CLOTHES WASHER <br />WATER HEATER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TON AUTHORIZED 15 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 HE PEERY CERTIFY THAT I HAVE READ AND FXAMINEO THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. Al •. <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYI <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERE " <br />OR NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME I <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS r <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT,(' <br />OR THE PERFORMANCE OF CONSTRUCTION <br />x <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.)-- <br />eUtl (VIAL <br />PERMIT i <br />TOTAL FEE 6 <br />SIGNATURE OF CONTRACTOR OR AUTH AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />—y,wl <br />.�FI/i'� <br />PLAN CHECK FEE <br />1 E E � RNO <br />USEZONE <br />LOT AREA <br />VACA.�T SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCU WCY GROUP <br />[�Y <br />NO. OF DWELLING <br />UNITS <br />_ <br />BUILDING <br />S <br />1 <br />1 <br />SIZE OF BLDG. <br />NO, OF SJORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONLy <br />a <br />BASEMENT <br />FIRESPRINKL RS <br />Rf OVIRED <br />OYES ONO <br />MECHANICAL <br />I <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />PENELTY <br />SEC, 303 IF) <br />TOTAL <br />j00 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />a <br />pWLICATI r_�FPTFD BY VLANS(3YTLD 9Y <br />gPPFOVEgf ISSUANL[BY <br />