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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 1590985 <br />EVERETT, WASHINGTON <br />98101 <br />DEPT. DE COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWNER MAIL ADDRLSS ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL OGRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />M ECHANICAi_ CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />f 717- • <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Uj <br />0] <br />PERMIT <br />❑BUILDING ❑PLUMBING ]MECHANICAL <br />CLASS OF iNORK <br />NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />� <br />z <br />♦_ <br />VALUATION OF SVORK <br />S <br />❑DEMOLISH ❑FENCE [I SIGN ❑SWIMMING POOL <br />cc <br />W <br />_ _ D. <br />DESCRIBE WORK 20 51 PuFam <br />288 <br />PROPOSED USE <br />MECHANICAL _ <br />TYPE OF FUEL ❑OIL []GNAT. LPG. ❑ELEC. <br />GAS <br />LEGAL DESCRIPTION OF PROPERTY ISH WW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS—H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />I <br />_ <br />JOB ADDRESS <br />WALL HEATERS-B.T.U. M <br />1 <br />UNIT HEATERS-B.T.U. M <br />! <br />EVAPORATIVE COOLERS <br />PLUMBING <br />_ <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />! <br />AIR HANDLING UNIT— C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET(TOILET) <br />S <br />_ <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />SHOWER <br />r <br />KITCHEN SINK & DISP. <br />SUBTOTAL S <br />!-- <br />DISHWASHER <br />PERMIT S <br />LAUNDRY -TRAY <br />TOTALFEE S <br />7W_ <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 />CONSTRUCTION OR WORK IS SUSPENDED OR ABANUONEO 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 '_AWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL LE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GR.INTING 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 />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 />S <br />TOTAL FEE <br />8 1 <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />BIDE YARD SETBACK <br />STREETSETBACK <br />REAR YARD SETBACK <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 />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNI OF DWELLING <br />J <br />BUILDING <br />S <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINK LERS <br />RF.OUIRED <br />❑YES ❑NO <br />MECHANICAL <br />1 <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />I <br />PENELTY <br />SEC. 303 (a) <br />T <br />I <br />TOTAL <br />qll� <br />- <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />0 <br />APPLICATION ACCEPTED BY: <br />PLANSLNECKEDBY: <br />APPROVED FOR ISSUANCE BY: <br />