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the Evergreen <br />CITY OF <br />eve nett <br />CITY HALL 2598885 <br />EVERETT, WASHINDTON <br />99201 <br />DEPT. OF COMMUNITY BUILDING <br />DEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING .e <br />OWNER pE� MAIL ADDRESS ZIP r��+yPH�O.yNL <br />:±a��,,� �Vftvw 33'� Am <br />�1 <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSL TIU. <br />5?46 <br />RR�A�9CT�,ORR ,. ♦ �,�{MAIL ADDRESS jam' �P}H�O�NE �L�� LICENSE NO. <br />GENERAL CONTRACTOR <br />L�9varea 4WD-LSiRiAY 5" %�. "IAV .Ao "f- ��ar.A"� 'a 'S.'L �[L <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cc <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />_ <br />LU <br />ro <br />2w <br />PERMIT <br />BUILDING ❑ PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />[I NEW ❑ADDITION 17PALTERATION ❑REPAIR <br />z <br />N <br />VALUATION OF WORK <br />�_'y^ti.M <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SHIMMING POOL <br />ED <br />DESCRIBE WORKrwime VV 2040 <br />6 5 6 <br />PROPOSED USE <br />MECHANICAL <br />TYPEOFFUEL ❑OIL ❑GAS. ❑LPG ❑ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIER) <br />LOT BLOCK —OF <br />_ <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-B.T.U. M EA. <br />I <br />JOB L9L.9�1 Y9t9`., <br />LKif 1f <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-O.T.U. M <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />I <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 />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUBTOTAL S <br />1 <br />DISHWASHER <br />PERMIT $ <br />LAUNDRY TRAY <br />TOTALFEE $ <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 SUSPEN^ED 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 DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAI N LEADERS_ <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />_ <br />PERMIT <br />$ <br />TOTALFEE <br />$ <br />SIGNATURE OF CONTRACTOROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <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 ❑NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />UNO. OF NITS DWELLING <br />BUILDING <br />$ <br />I <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />RFOUIRED <br />❑YES []NO <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />PENELTY <br />SEC. 303 (e) <br />I <br />TOTAL <br />I <br />1� <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />3 <br />APPLICATION ACCEPTED OY: <br />PLANS [NECKED BY: <br />APPROVED FOP ISSUANCE BY. <br />