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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2598885 <br />EVERETT. WASHINGTON <br />B8201 <br />DEPT. OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING <br />OWNER MAIL ADDRESS ZIF PHONE <br />7AY AiA-PO XK7W <br />U2-77 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL �CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />«�J Vilonl!14 <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />ED <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />ED <br />m <br />PERMIT <br />(7.BUILDING JUPLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />❑ NEW T ADDITION ❑ALTERATION ❑REPAIR <br />� <br />Z <br />i <br />VALUATION OF WORK <br />$ <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />2 <br />— W <br />DESCRIBE WORK <br />= � <br />ll s <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL ❑NAAT. ❑LPG. ❑EL EC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW Olt ATTACH <br />FOUR COPIES) <br />LOT 3 BLOCK—OFVIM TP&I'm <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 />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-O.T.U. M EA. <br />I <br />JOB ADDRESS <br />2i'':2 Jaml mF <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS—B.T.U. M <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />i <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />AIR HANLLING UNIT- C.F.M. <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET (TOILET) <br />$ <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />DISHWASHER <br />SUB TOTAL $ <br />PERMIT $ <br />I <br />LAUNDRY TRAY <br />TOTAL FEE $ <br />I <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED W:THIN 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 />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAI N LEADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUBTOTAL <br />_ <br />$ <br />PERMIT <br />TOTALFEE <br />$ <br />3IGNATUREOFCONTRACTOROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARDSETBACK <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 COOT. <br />OCCUPANCY GROUP <br />O. OSF DWELLING <br />UNIT <br />I <br />BUILDING <br />S �, ( <br />j00 <br />SIZE OF SLOG. <br />NO. OF STORIES <br />MAX.00C.LOAD <br />PLUMBING <br />(' <br />FIRE ZONE <br />BASEMENT <br />FIRESPI KLERS <br />❑V ES ❑NO <br />MECHANICAL <br />I <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENELTY <br />SEC. 3031N) <br />TOTAL <br />I <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />3 <br />APPLICATION ACCEPTED BY: <br />PLANS CHECKED BY: <br />SUANCE BY <br />r7ce <br />