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__ 1 <br /> � .,�� , �, ,,� � � <br /> ; ���� �� CaNSTRIJCTION �everet� I, <br /> � everett PERMIT i <br /> �„�,,,<< �s., ,, � <br /> I CVEPEII.GAs�IViC,inq �/ <br /> � 3Pl 11 � <br /> "r` °""•''°°"` BUILDING MECHANICAL PLUMBING <br /> ' CiVkIJ�'.IE4t � <br /> iOWNER MAILADDRE`S ZIP PHONE � <br /> ....�. . .t�':�:.if il- i r7i �Ji��. ":'T�'�� 9 � <br /> .:. �.-. . , _ .:(��. f �:1Z,�• ,...a.� ����=.sl7tis, � i .� i <br /> �i ARCHITECT OH pE51GNER MAIL AODflESS ' PHpNE LICENSE NO. �� �� i <br /> I <br /> GENERALCONTRACTOR MAILHODRESS PHONE LICENSENO. <br /> � <br /> IdECHA,JICAL CONTRlaCTOR MAIL ADDflE55 PNONE LICENSE NO. <br /> i <br /> I <br /> � PWM�ING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. �" I <br /> W <br /> � m <br /> I �'��{M1��T CLASS OF WpRK j <br /> � <br /> :L] 6UILDING � PLUM6ING �MECHI�NIGAL z <br /> . ❑NEW �ADDITION ❑AITERl1TION ❑REPAIft ~ <br /> � � <br /> � VALUATION UF WORK � <br /> s yp����}y� ❑OEMOL'Sfl ❑FENCE ❑SIGN ❑SWIh1MiNG POOI W <br /> b y! y <br /> DESCRI6E WOFK - ----- <br /> �t..^�^@ ?i� :-Mi �;xr,d,.t ���i� <br /> � ' I <br /> I PROPpSED US[ � <br /> MECHANICAL i <br /> � rv�EOFFUE� �oi� �Nni—�ir� �eiEc. I <br /> � L@GAL DESCHIPTION OF PROPERTV ISHOW BELON'OH ATTACH �,/�g <br /> I FOUR CQPIE51 <br /> I' �_�T '� oLOCK_oF n-�i`�!6�: ���� �� :�ii NO. TVPEOFEQUIPMENT FEE i <br /> I AIR COND. UNITS-H.P. EA. 5 I <br /> � REFRIG[RATION UNITS-H.P. EA. I <br /> - QOILERS-�H.P. EA. I I <br /> � GAS FIRED A.C. VNITS-TONNAGE EA. <br /> � ____ FORCED AIR SVSTEMS-B.T.U. M EA. � I <br /> JOB A�DFESS /�-�r�.,� 'y�s WALL HEATERS--D.T.U. M <br /> I �" ��y �'���'p UNITHEATERS-e.T.U. M I <br /> � EVAPORATIVECOOLERS I <br /> I PLUMBING CLOTHESDRVERS � I <br /> � VENTILATION FAN I <br /> i <br /> I FAWGEHOOO � I <br /> iNO. TyPE OF FIXTURE OR ITEM FEE �+IR HANDLING UNIT- 0.F1d. <br /> I N/l1TER CLOSET(TOILETI 5 INCINEflATOA _ � <br /> �ATHTUB <br /> LAVATORVIWASH �ASIN) <br /> i SHOWER —��— � I <br /> KITCHEN SINK R DISP. SU6 TOTAL S <br /> OISHW4SHER T— PERMIT $ I I <br /> I LAUNDfiY TfiAV TOTAL FEE 5 <br /> CLOTHESlKASHER I <br /> ' IVI�T[R HEATER THIS PERMII' BECOMES NULL AND VOID IF WORK OR GONSTRVG I <br /> -- _ TION AUTHOflIZED IS NOT COMh16NCED WITHIN 120 DAYS, OR IF I <br /> I — URINAL_ � CONSTqUCTION OR WORK IS SUSPEIJOEO OR A�AN�ONED FOF A <br /> DfiINKIP:� rOUNTAIN PERIOD OF 120 DAVS nT qNV TIME 11FTER WORK IS COMMENCE0. � <br /> � _ FLOOF-$INK OR DFAIN I I II[FE6V CEf�TIFV THAT I HAVE READ AND EXAMINED TYIS AP� I <br /> VACUUM I7REl1KER5 WLICATWN AND KNOW THE SAME TO DE TRUE AND CORRECT. nLL j <br /> I ROOF DRAINS-RAINLEAOERS - { PROVISIONS OF Ll�WS AND Oi�D�NANCES GOVERNING THIS TVPE <br /> -- O. WOFlY. W�LL BE COMPLIEO LVITH INHETHER SPECIf-IED HEfiE1N <br /> I� SINK (SERVICE-DAfi, ETC.1 Ofl NOT, THE GRANTING OP q PEPMIT DOES M1OT PRESUME TO I <br /> GIVE l�VTHORITI' TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHGH STATE pq IOCAL LAW REGUTATING CONSTRUCTION <br /> � OR iH[ PLRFOfiM1L1NCE OF CONSTRVCTION. i <br /> ' SUBTOTAI _ { <br /> i PERMIT 5 <br /> i TOTAL FEE 5 __ <br /> X �n <br /> . I <br /> $IGNATUREOFCONTRACTORORl�UTH.AGENT �FTE <br /> � <br /> SIDE V/�RDSET6ACK STRE[T SET6ACK REAF,VAliDSET�ACK PLAN CHECK NUM6ER PLAN CHECK FEE I <br /> �"�j'f7a FEE ^1'�'J'� RECEIPTNO. <br /> j•i'1 ( JJ �„�� <br /> i USE ZONE LUT AREA VACANT SITE — , <br /> []YES ❑NO FEES VALUATION FEE <br /> I TVPE OF CONST. OCCUPANCY GROUP NO.OF �WELLING <br /> UNITS � <br /> I 512E OF 9LDG. PIO. OF STOf11CS Mnx. nCC. L^�l0 CUILOL^:G $ y,j��y� 4 I r <br /> II — y��� (.— <br /> � PLUMBING <br /> � i <br /> FIREEONE 6ASEMENT FIRESPqINKLEFS . _. � <br /> I HLUUIH6U � <br /> ❑VES ❑NO MECHANICAL <br /> j I <br /> SPECIALCONDITIONS: OTHER � I <br /> � I <br /> PENELTV SEC. 7031.�) I <br /> ' --_ TOTAL qr�� <br /> .:J iPERMIT VALIDATION � <br /> i — lNi1FU P�inPrPi v vn.i_!_... EC :... .���,,,,� .�,�� Tni� iS YUUN PhHM1T � <br /> I <br /> l I <br /> � I <br /> i <br /> ,� AVVIILnilpl;l.CCin{�pny .Ild'SC�IECKEppY: qPP00VE0FOhp'�.,OAtlCL6T. � <br /> ii �� <br /> � n I <br /> � <br />