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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />COMBINATION • BUILDING • MECHANICAL • PLUMBING <br />�eli <br />evere n <br />OWNER MAIL ADDRESS z1f, 1111r)NI.- <br />R. A. Robinson 612 34th Street <br />.D <br />m <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />z <br />C <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Eyelander Electric <br />W <br />W m <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />iT 1 <br />PERMIT CLASS <br />CCOMBINATION <br />❑ BUILDING [:I PLUMBING $]MECHANICAL <br />Of WORK <br />- <br />[I NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />' <br />VALUATION OF WORK <br />S <br />❑DEMOLISH [:]FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF ENERGY <br />[]GAS ❑FLEE. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF <br />...._— <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS--H.P. EA. <br />S I <br />REFRIGERATION UNITS—H.P. EA. <br />BOILERS—H.P. EA. <br />I <br />FORCED AIR SYSTEMS—B.T.U. MEA. <br />I <br />,0[1 ADDRESS <br />61.2 34th Street <br />SPACE & WALL HEATERS — B.T.U. <br />UNIT HEATERJ-B.T.U. <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGEHOOD <br />1 <br />NO. 1 <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />$ <br />CLOTHES WASHER <br />1 <br />WATER HEATER <br />DISH WASHERS <br />I <br />PAC. BUILT FIREPLACE & CHIMNEY <br />I <br />DRINKING FOUNTAINS <br />1 <br />GAS. SYSTEM: NO OP OUTLETS <br />FLOOR DRAINS <br />I <br />SUBTOTAL S <br />I <br />KITCHEN SINKS & DISP. <br />I <br />PERMIT S <br />BAR SINKS <br />I <br />ROOF DRAINS - RAIN LEADERS <br />I <br />TOTAL FEE <br />7 I 00 <br />SHOWER BATHS <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 1 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 />,,///f <br />X 4+Myy "• `�"Q./� 10/10/7 <br />SERVICE SINKS <br />SUMPS -SEWAGE PUMP <br />URINALS <br />1 <br />WATER CLOSETS <br />I <br />WATER HEATERS - ELECTRIC <br />I <br />WASH BASINS <br />1 <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />I <br />_ <br />PERMIT <br />S <br />TOTAL FEE <br />WATER <br />SERVICE SIZE BLDG. SUPPLY <br />SIZE <br />N UREOPC TRj OROR .AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARDSETBAC <br />P CHECK NUMBER <br />PLAN CHEC FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />WO UNITSOFDWELLING <br />BUILDING <br />S <br />I <br />I <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRESPRINK LEES <br />REQUIRED <br />❑YES []NOYES <br />MECHANICAL <br />7100 <br />SPECIAL CONDITIONS: <br />OTHER <br />I <br />_ <br />PENALTY <br />SEC. 303(a) <br />T <br />I <br />TOTAL <br />_ <br />7 1 O O <br />PERMIT VALIDATION <br />WHENP Y 'A LIOATED II 4 7,I C p PAC ♦ I .Ft;7TMMI4 <br />W <br />YOUR RECEJMI , <br />THANK YOQ,�. <br />] <br />APPVCATION ACCEPIEU I:P <br />PLANS CHECK LD BY: <br />APPROVED FOR ISSUANCE by. <br />ADDRESS FILL=. <br />