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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 2599885 <br />EVERETT, WASHINGTON <br />98201 <br />DEPT. OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING ,e <br />OWNER r�yrr�t� ♦/TL D > MAIL ADDRESS ZIIP�, 1114O.�NEE <br />4♦ T • �Rrl+V1 .lU�d �i :�F�l...i�ni .�iM 1..':.i �- .i JL%�Ti �iViV <br />i:.4r��/'l: <br />ARCHI 7ECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />rAT n <br />MECHANICAL CONTP...CTOR MAIL ADDRESS. PHONE LICENSE NO. <br />.N9 ft <br />W <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />Go <br />PERMIT <br />BUILDING 99 PLUMBING ETm ECHANICAL <br />CLASS OF WORK <br />'X3 NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />D <br />~ <br />VALUATION �OF WORK <br />5 <br />❑DEMOLISH ❑FENCE ❑SIGN []SWIMMING POOL <br />d <br />DESCRIBE WORK <br />PT.:_= I%1�'?r.-No <br />�t 1 `'� �j <br />V Q J <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL []OIL []NA. ❑LPG. ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR CO PIESI _ <br />LOT I&W BLOCK OF A - if <br />�E �L �{� 'ate <br />W t: L y� � Q? tS 11 S+60V <br />NO. <br />TYPES- EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S 1 <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />I <br />- -'alV} Li.. 40t 12 M <br />- <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />51 c <br />JOB ADDRESS P q <br />J�J:'!7 ¢ `;r .,r <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 />T— <br />RANGE HOOD <br />1 <br />AIR HANDLING UNIT- C.F.M. <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 />_ <br />KITCHEN SINK & DISP. <br />SUBTOTAL 5 <br />I <br />DISHWASHER <br />PERMIT $ <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 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 />_, <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR, ETC.) <br />_ <br />SUB TOTAL <br />_ <br />PERMIT <br />5 �4 <br />TOTALFEE <br />$I <br />SIGNATURE OF CONTRACTOROR AUTH. AGENT DATE <br />SIDE.Ylk%QSETSACK <br />��{ <br />STREET SE�K <br />REAPYARD SETBACK <br />(i.`y1 <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE 1�05 50 RECEIPT NO. <br />USE 4S]IyF <br />ACM <br />LOT AREA <br />V7p��ANT SITE <br />j=JYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF OVj LLING <br />UNITS <br />Iry� <br />BUILDING <br />�}yy� <br />5 <br />SIZE OF BLDG. <br />NO. OFaSTORIES <br />'L <br />MAX. OCC. LOAD <br />PLUMBING <br />J co <br />FIRE ZQNE <br />.7 <br />BASEMLg7� <br />3['.l'i <br />EflS <br />FIRE REQUIRED <br />REGUERED <br />DYES NO <br />_ <br />MECHANICAL <br />P. <br />I VICQ <br />SPECIAL CONDITIONS' <br />OTHER <br />I <br />I <br />PC <br />PENELTV <br />SEC. 303(a) <br />I <br />• iMamim <br />TOTAL <br />ws: - T) <br />&1PAffjo Mir, .. er.. jWr <br />9.' : !Alxvu uf4 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />fI <br />APPLICATION ACCEPTED BY: <br />PLANSCHECKEO BY'. <br />APPROVED LO ISSUANCE RY: <br />