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- file Evergreen - - - - - CONSTRUCTION ® everett <br />CITY OF PERMIT <br />eve rctt <br />CITY HALL 2BBB745 . BUILDING MECHANICAL • PLUMBING <br />EVERETT. WA 98701 COMBINATION ._ <br />1 <br />UcvNLR <br />� in1 <br />MAIL AUDI/L:iS <br />122�A�I <br />/'-r Pr1 Ltl<I � <br />ur <br />r /jam. <br />�..��_ <br />- - <br />06203 7ISE <br />SIGNER <br />ARCHI E OR DESIGNER <br />MAIL ADO!1LS:i <br />P11UNE <br />(<U�11'IY�) <br />LICENSE <br />1 <br />cI00 4 <br />Ayl�- 1o22-g�o', <br />- <br />K i25J l ��J JP'T6 <br />- <br />JG <br />MAIL AUORES.. <br />PHONE <br />LICE - <br />GLNLKALCON ACTOR <br />_ <br />OW�jF IL.- — <br />MAIL ADDRESS <br />PIIONr. <br />LICENSE <br />MLCHANICALCONTRACI <br />N <br />p <br />' O't Pj /'-�G <br />IsSPc�vP <br />PNONE <br />LICENSE <br />I PLUMBING CONTRAUIVR <br />IJO•JJ'� <br />PERMIT <br />❑ COMBINATION <br />>4UILDING ❑PLUMBING ❑MECHANICAL <br />VALUATION OF WORK <br />E i on. <br />DESCRIBE WORK <br />ZtG(b G7Z mP.11...)i <br />P II OP05E0OSE <br />I.LGAL OESCRITTION OF P <br />I OUR COPIES) 1) <br />LOT BLOCK <br />B ADDRESS <br />PLUMBING <br />B <br />I <br />Ery NE IN Cl AD UI T ION ❑ALTERATION ❑REPAIR <br />❑DEMOLISH ❑HENCE ❑SIGN ❑SWIMMING POOL <br />MECHANICAL <br />TYPE OF FNERGY UGAS ❑ELEC. <br />NO. _ _ _ TYPE OF FOVIPMENT FEE <br />AIR COND. UNITS-ILEA. T- <br />-- IEf RILL RATION ITS EA. <br />IT ILP. <br />IOILT RS II.P.EA. I _ _ <br />FURCEU Alll'SY STFMS-U.T.U. MEA. _ —r <br />-- I <br />$PnUNIT ICf. AAwALL HL n7e Rs - e. T.11. <br />IETE I" R T U.__—__ I <br />EVAPORATIVE COOLERS { <br />� cCDnliti i)nvLRs 31 <br />VENIILATIUN FAN <br />IIANGC <br />A 111 IRA NULINI UNIT- C.F.M. <br />WATCH IIEA_TE11 <br />TIC. IIUILT FIREPLACE A CHIMNEY T_ <br />GAS. SYSTEM: NO OF OEITLEIS <br />TRIAL <br />PF.IMR f—�� <br />TU TAL FEE f LOIN_ <br />THIS PE IIAIIT ILL GOAT ES NULL ANO VOID IF WORK O­RC ST RUC <br />1 ION AU f 11011111 D IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONST IIUCI ION Oft W(IIIK IS, SU.,PENDED OR ABANDUNLD FOR A <br />PI I110U UR' 170 DAYS A ANY IIME AT TER WOIIK IS COMMENCED. <br />I I11. 11LHY (.I.RTIFY MAT I HAVE DEAD AND EXAMINED THIS AP. <br />PI ICAIION AND KNOW THI: SAME TO HIE TIIUE AND CORRECT. ALI. <br />P IIUVII:IINS 01 1 AWS AND UIIDINANCLS GOVERNING THIS TYPL <br />Of WORK WILL BE CUMrI.IEO WIT14 WHETHER SPECIFIED HEREIN <br />O11 NO1, 711E (WANTING OF A PERMIT ODES NOT PRESUME TO <br />GIVE AUfIIOIITV 70 VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY 0111CI1 :LATE OR IOCAL LAW IEGULATING CONSTRUCTION <br />OR 111E PL11f OIIMANCC OF CONSTRUCTION. <br />TO TA LFEF <br />fI 7�lOn <br />X �t✓ <br />_ V_ _ <br />Nnlll ilC Dl TTtACI <br />)(. � AX . u<. T <br />110 T1 AU TH .` EN DAT <br />_ <br />ViA1EA SERVICE SIZE ULOG, SUPPLY SIZE —SIG <br />!AOL YAIi USLTUACK <br />STPEcT SETBACK REAR YAHOSLTBACr <br />PLAN CIILCP. NUMIIEII <br />PLAN CHECK FEE <br />RµL/CEIPT <br />(p <br />'LEFT <br />Z cFT <br />FEE <br />nNO. <br />2,-2— <br />OSL 20NE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />R-� <br />❑YES QW0 <br />I YPL OF CONST. <br />OCCUPANCY GROUP <br />UNITS OWL L LING <br />_ . - /J <br />R 3 <br />I <br />LOAD <br />- <br />BUILDING <br />f QO 060 ' <br />/ <br />8/ iQ�i <br />SIZE OF BLDG. <br />NO. OF 5TORIES <br />MA %. OCC. <br />-- <br />- <br />Pt LIMITING <br />— <br />1 <br />I <br />1 <br />�- <br />I I�IC ON <br />BAS MEN7 <br />FIRE�IP 1i1NK Li-RF'I— <br />REOUIRED <br />y�C <br />❑YES ❑ND <br />MECIIANIC.A). <br />1 <br />!.I,L CI AL CONDITIONS: <br />OTl41711 <br />_-- <br />rfNALIY <br />St C. 7U:1 Id <br />I <br />1 <br />_ <br />IF /S Ft�+�Ck7� <br />1?CG FFE7aTlEv4 <br />_.---r <br />TOTAL <br />- -- <br />l i d(zl <br />PFRMIT VAI IOATiON <br />Y:111 N I'RUi'1 RI.Y VALID AICD <br />DN III$ $I'ACEI <br />TITS IS YOUTi PERMIT <br />�c <br />I <br />N I'l IL/A 11111 A111�1111 Y♦ vl nA'.l�R a10LI__--_ <br />I'PINVlll lllll ^,iSIInKKI NY <br />