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the Evergreen <br />CITY OF <br />everett <br />CITY HALL b98885 <br />EVERETT, WMHINGTON <br />BB201 <br />DEFT. OF CONNIINITY BUILDING <br />OEVELOPMENT <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING ,.e�� <br />OWNER MAIL ADDRESS ZIP pHO E <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE I.ICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />03 <br />PERMIT <br />BUILDING []PLUMBING []MECHANICAL <br />CLASS OF WORK <br />❑NEW ADDITION ❑ALTERATIOIJ ❑REPAIR <br />� <br />z <br />F <br />VALUATION OF WORK <br />S ` 1 <br />❑DEMOLISH []FENCE ❑SIGN ❑SWIMMING POOL <br />Cr <br />d <br />DESCRIBE WORK CCi3str. bra W to mrl �,tu. Q;i mo f 1 u' Yoxt <br />7�r'M <br />1533 <br />PRUPOSED USE <br />MECHANICAL <br />TYPE OF FUEL []OIL ❑NAT. ❑LPG. ❑ELEC. <br />GAS <br />I EGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) y� <br />LOT � �. 2 BLOCK ��X OF <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S 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 />sy,i <br />JOB ADDRESS pIa}� Paa 33 id <br />T3SOi J u <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <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(TOILETI <br />S <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I _ <br />SHOWER <br />KITCHEN SINK & DIST. <br />SUB TOTAL S <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 />COI'JSTRUCTION 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 HEAD AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUF 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 />7,R,wry�ly[ <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />BREAKERS <br />ROOF DRAINS EADERS <br />SINK (SERVICE -BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />4 <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />S1DE 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 />NO. OF DWELLING <br />UNITSyy�� <br />IyyF <br />BUILDING <br />M <br />S 75ilpW <br />5 im <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />I <br />I <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINKLERS <br />REOUIRED <br />OYES [:)NO <br />MECHANICAL <br />I <br />SPECIAL CONDITIONS: <br />OTHER <br />PENELTY <br />SEC. 303(a) <br />I <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPE RLV VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />9 <br />APPLICATION ACCFPTEF BY: <br />PLANS CHECKED BY' APP <br />NOVEOFOP ISSUANCE BY. <br />i!F co- <br />