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the Evergreen <br />CITY OF <br />everett <br />EITY HAIL maul <br />EVE RETT, WASHINGI ON <br />91201 <br />D[IT DE EMITY BUILDING <br />OLYILOPlOPM1M1 <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e� <br />MAIL ADDRESS ZIP PHONE <br />Lry <br />ARCHITECTOR D E SI NNER MAIL ADDRESS PHONE LI ENSE NO. <br />/'TT /%— <br />GENERrEA��L CO�N/T�RACTO.R MAI <br />F�L ADDRESS �•��E PHefOAN.yE� LICENSE NO. <br />IF �L30. wEo —0 17% Y .r3! J� itiJ7C GGT� FAi Eli <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />r <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cr <br />LU <br />m <br />PERMIT <br />BUILDING ❑ PLUMBING ❑ MCCHANICAL <br />CLASS OF WORK <br />❑NEW ❑ADDITION ❑ALTERATION [TAEPAIH <br />2 <br />D <br />Z <br />VALLI ATIO ORK <br />$ <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />S_ <br />W <br />DESCRIBE WORK <br />a <br />C_ <br />PROPOSED USE <br />MECHANICAL <br />LEGAL DESCRiPI'ION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR �IES) M1{N��I�!, <br />LOT i� BLOCK 0'bF_0,MUTr tVa A <br />TYPE OF FUEL ❑OIL ❑NAT. Q LPG. ❑ ELEC. <br />GAS <br />NO• <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />_ <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />I <br />__ <br />BOILERS-H.P. EA. <br />1 <br />GAS FIRED A.C. UNITS-TONNAIE EA. <br />I <br />FORCED AIR SYSTEMS—B.T.U. M EA. <br />I <br />J]B ADDFlE55 .��.9E� MIz mo <br />WALL HEATERS—B.T.V. M <br />UNIT HEATERS—B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE^OOLERS <br />- <br />CLOTHES DRYERS <br />VENTILATION FAN <br />_ <br />RANGEHOOD <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT— C.F.M. <br />WATER CLOSET(TOILET) <br />$ <br />INCINERATOR <br />1 <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />f <br />SHOWER <br />_ <br />KITCHEN SINK <br />SUBTOTAL $ <br />I <br />DISHWASHER <br />LAUNDRY TRAY <br />— <br />_ _ PERMIT $ <br />CLOTHES WASHER <br />TOTAL FEE S <br />WATER HEATER <br />THIS PEgM1T 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 />x +� <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR —SINK OR DRAIN <br />VACUUM BREAKERS <br />HOOF DRAINS—RAINLEADERS <br />SINK (SERVICE —BAR, ETC.) <br />SUB TOTAL <br />PERMIT $ <br />TOTAL FEE $ <br />SIGNATU RE OF CONT RACTOR OR AUTH.AGENT _DATE <br />SIDE YARD SETBACK <br />STREET SE76ACK <br />REARYARDSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONS_. <br />OCCUPANCY GROUP <br />NO. OF DWELLING <br />UNITS <br />I <br />SIZE OF BLOG. <br />NO. OF STO R I ES <br />MAX.00C.LOAD <br />BUILDING <br />5 1E <br />�I <br />I <br />PLUMBING <br />I <br />FIRE 20NE <br />BASEMENT <br />FIRESPRINKLERS <br />RCOUIRED <br />OYES ❑NO <br />MECHANICAL <br />OTHER <br />1 <br />SPECIAL CONDITIONS:_ <br />-. <br />- <br />I <br />1 <br />PENELTY <br />SEC. ]0] (A) <br />I <br />TOTAL <br />20 tOO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />B <br />nFPLICATION ACCEPTED BY: <br />PLANS CHECKED BY: <br />APPROVED FDA ISSUANCE BY. <br />� ce <br />