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Ithe Evergreen <br /> ���� o� COIVSTRUCTI01� everett <br /> everett RERMIT <br /> crtrrwu rs�eees <br /> EVEH[rr,wns��ixcrou <br /> seem <br /> °�P� °� �°^�"°°��r BUILDING MECHANICAL PLUMBING <br /> ocvEiormcNr <br /> OWNER MAIIADDPE55 ZIP PHONE — I <br /> �,a�:_ari: •'�yC:i` .: l••i: 'lS:' :�tTRF.L 1119-'17 <br /> ARCHITECT OR DESIGNER MAIL ADORE55 PHOfJE LICENSE NO. <br /> GENERALCO(<TRACTOR MAILADORESS PHONE LICENSENO. <br /> MEGHANICALCONTRACTOR MAILADDR[55 PHONE LICENSENO. <br /> :Fa�ur:::. �su �::�Li?:,k:nt t:rn:;uv:y cc <br /> PLUM6ING COfv7FACTOR MAIL AODiiE55 PHONE LICENSE NO. W <br /> m <br /> PEftM1T �LASS OF WORK � <br /> z <br /> ❑ pUILDING ❑ PLUM�ING �M[CHANICAL ~ <br /> ❑NEW ❑A��ITION ❑l�LTERATION ❑REPAIR � . <br /> VALUATION OF WORK ^� � <br /> ❑D[MOLISH ❑FENCE ❑SIGN uSWIMMING POOL w <br /> s -- — <br /> a <br /> DESCRIBE WOFK 2 g�� <br /> aaoroseo usE MECHANICAL � <br /> TYPEOFFUEL 'i�O�L �Gns. �LPG. �ELEC. <br /> LEGAL OESCFIPTION OF PROPERTV ISHOW BELOW OR ATTACH <br /> FOUR COPIESI -- <br /> I NO. TVPE OF EOUIPMENT FEE <br /> LOT BLOCK_OF qIR CONO.UNITS-H.P. EA. 5 I <br /> flEFRIGEFATiON UKIiS-H.P. EA. <br /> I ROILERS-H.F_ FA. � <br /> GAS FIftED A.C. UNITS-TONNAGE EA. <br /> FORCED AIR S�STEtdS-A.T.U. M EA I <br /> JOD ADDRE55 « WALL HEATER$ _R.1.U. fd <br /> .('���J'� 3r3 J�:YE3C3ti UNIT HEATERS-6.LU. M � <br /> E V APO f�AT I V E COU LE RS <br /> PLUMBING CLOTHCSDRVERS � I <br /> VENTILATION FAN T <br /> RANGEMOOD � <br /> AIR HANDLING UNIT- C.F.M. � <br /> NO. TYPE OF FIXTURE OR ITEM FEE INCIfJERATOR I <br /> _ WATERCLOSET(TOILETI 5 � �x• iQa�.�+r� � �_ <br /> BATHTUB — — <br /> LAVATORYIWASHBASIW � <br /> - --r <br /> SNOWER — �—.�{- <br /> KITCHENSINK & OISP. SUBTOTAL 5 4 � '� <br /> DISHWASHER PERMIT $ ','�" <br /> LAUNORY TIiAV TOTAL FEE 5 '� I "�� <br /> CLOTHES WASHER THIS PERMIT IiECOMES NULL AND `/OIO IF WORK OF CONS'fRUG I <br /> WATGR HEATER TIOtJ qUTHORIZED IS NOT CJMMENCED WITHIN 120 �AYS, OR IF <br /> URINAL CONSTRUCTION OR N'ORK IS SUSP[NOEU OR AkIANDONEO FOft A <br /> —� AEflIOD OF 120 DAVS AT ANV TIME AFTER WOftK IS COMMENGED. <br /> DRINKWG FOUNTAW T_ <br /> FLOOH-SINK OR �fiAIN I NERE6Y CEP.TIFY THAT I HAVE REAb AND EXAMWE� TFUS AP- <br /> PLICATION AND KNOW l'HE SAME TO �E TRUE l�NU CORRECT. ALL <br /> VACUUM OREAKEFS PROVISIONS OF LAWS l�ND ORDINANCES GOVERNING THIS TYPE <br /> ROOF �RAINS-RAINLEADC-PS OF WORK WILL BE COMPLIED W�TN WHETHER SPEGFIE� HENEIN <br /> SINK (SERVICE-BAR, ETC.) OFi NOT, TF1E GRANTING OF A PERMIT DOES hOT PRESUME TO <br /> -� GN[ AUTHORITY TO VIOLATE OH CANCEL THE PROVISIONS OF <br /> ANV OTHER STATE OR LOCAL LAVJ REGULATING CONSTRUCTION <br /> __ UR THE PERFORMANCE Of CONSTRUCTION. <br /> SU� TOTAL —� <br /> PERMIT 5—� <br /> TOTALFEE 5--� 7�7I.�7 <br /> x <br /> SIGNATUREOFCONTRACTOROFAUTH.t1GENT UATE <br /> I SIDE YAHD SET6ACK STFEET SET6ACK REAR Yl1RDSET9ACK PLAN CHECK NUM�ER PLAN CHECY. FEE <br /> FEE RECEIPT NO. <br /> USE 20NE LOT AREA VACl�NT SITE <br /> ❑vEs ❑No FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF �WELLING � , <br /> UNITS <br /> _' ' _ <br /> 512E OF OLDG. NO. OF STONIES Ml�X.00C. LOAD BUILDING 5 I <br /> PLUM�ING � <br /> FIRE20NE 6ASEMENT FIFESPRINKLEftS � <br /> RC(]UIRE� '� � '� <br /> ❑VCS ❑NO MECHANICAL � I <br /> I <br /> SPECIAL COND�TIONS: OTHER � <br /> —I— <br /> F'ENELTY SEC. 3031a1 � <br /> --- — --- y I i'i 1 <br /> -- -- TOTAL � <br /> ('ERMIT VALIDATION <br /> - -- WHENPROPERLVV�LIDATEDIINTHISSPACE1TH1515�'OURPERMIT <br /> 4 MPtICAiIORPCCEPTf00Y �LM6CHECKC�OY FFPOOV[U�ON,SSO�N.[5Y <br /> i I I , .n <br /> � <br />