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the Evergreen <br />CITY OF <br />everett <br />CITY HALL ESS 8895 <br />EVERETT, FR INGRIN <br />11DR1 <br />DEPS. DE CUL111URITY BUILDING <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNER MAIL ADDRESS ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />f , <br />GENERALCONTRACTOR MAIL ADDRESS PHONE LICENSENO. <br />1), A, DU37M rs ro, <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />tD <br />2 <br />PERMIT CLASS <br />❑ BUILDING ❑ PLUMBINJ [ MECHANICAL <br />OF WORK <br />❑ NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />:D <br />Z <br />r <br />VALUATION OF WORK <br />;r ❑DEMOLISH ❑FENCE []SIGN ❑SWIMMING POOL <br />$ 3.0 <br />DESCRIBE WORK <br />4AfA V..iV <br />W <br />a <br />2073 <br />PROPOSED USE <br />MECHANICAL <br />TYPEOFFUEL ❑OIL ❑GAS ❑LPG. ❑ELEC. <br />FOUAL DESCS)IPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />�' 717 Piet Of "amlott. <br />LOT BLOCK —OF <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H-P, EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. - <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-R.T.U. M EA. <br />M <br />I <br />JOB ADDRESS <br />3030 .irtmrO <br />WALL HEA: ERS-B.T.U. <br />UNIT HEATERS-B.T.U. M <br />I <br />__ <br />EVAPORATIVE COOLERS <br />PLUMBING <br />' <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />WATER CLOSET (TOILET) <br />$ <br />BATHTUB <br />SUBTOTAL S <br />PERMIT $ <br />I <br />_ I <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />DISHWASHER <br />T <br />LAUNDRY TRAY <br />TOTALFEE $ <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 />OR WORK ISOR ABANDONED FOR A <br />PERIOD OFTION 120 DAYS AT ANYSUSPENDED TIME AFFTEn WORK S COMMENCED. <br />1 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 />2-:!L-77 <br />x <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />PERMIT <br />$ <br />TOTAL FEE <br />$ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT GATE <br />SIDEYAROSETBACK <br />STREETSETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YEB ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNITE DWELLING <br />I <br />BUILDING <br />$ <br />I <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />R O <br />OYES YES ONO <br />MECHAE11CAl <br />1 <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />PENELTY <br />SEC. 3031F) <br />I <br />TOTAL <br />u LY've1 1neTInN <br />I� <br />THEN PROPE PLV VALIDATED (IN T11IS SPACE) THIS IS YOUR PERMIT <br />