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the Evcigreen <br /> ��T� �� CQNSTRUCTION everett <br /> �veret� PERMIT <br /> orrw�u 1s��rn.-e <br /> lVf Ff li.'i:4$!IINuIO'1 <br /> 9A���� BUILDING MECHANICAL PLUMi31NG I <br /> n[vr m ca�nr.iuxrtr <br /> r,ivuor�aurt <br /> OWNEH MA�Ll�ODfiESS ZIP PHONE <br /> �i�l�n JtiVr�.:./ 1'��'1% <br /> ARCHITEGT OR DESIGNEP MAIL ADDRE55 PHONE LIGENSE NO. <br /> GEN[RALC� 'T^ACTOR MAILAODRE55 PHONE LICENSENO. <br /> MECHANICALCONTRACTCR MAILADDRG55 PHONE LICENSENO. <br /> J�.t.i:; Y _�la1c � <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. uJ <br /> m <br /> � <br /> PEftM1T CLA55OF WORK � <br /> z <br /> � �UILDING �PLUMBING Q SECHANIC/1L ~ <br /> ❑NEW ❑ADDITION ❑ALTERAI'ION ❑REPAIP � <br /> � <br /> VALUATION OF WORK w <br /> ❑DEMOLISH Of-ENCE ❑SIGN ❑SWIMMING POOL S <br /> $ <br /> DESCRIOC WORY. +')��j � <br /> � S <br /> PROPOSEO USE MECHANICAL <br /> TYPEOFFULL �n�L ❑GAS� ❑LPG. �ELEC. <br /> LEGAL DESCRIPTION OF PROP[RTY (SHOW�ELOW OF ATTACH <br /> FOUR COPIESI <br /> NO. TYPE OF EQUIPMEN7 FEE __ <br /> LOT BLOCK—OF qIR COND.UNITS-H.P. EA. 5 � <br /> Rf.FflIG@RATION UNITS-N.R EA. —�_ <br /> I fiOILEFS-H.P. LA. � <br /> GAS FIRED A.C. UNITS-�TONNAGE EA. <br /> PORCEDAIRSVSTE�iS-B.T.U. MEA. I � <br /> —r <br /> JO� AODRE55 ��M1'�+LL HEATEHS-�.T.U. M _ _ <br /> 4'��.,5 :IY.R �SC=CBt _IUNITHF.ATERS-B.T.U. M � <br /> �EVAPORATIVE COOLERS �_ <br /> PLUMBING e�onies oaveas i <br /> VENTILATION FAN � <br /> RANGEIi00D � � <br /> AIR HANOLING UNIT- C.F.M. <br /> NO. NPE OF FIXTURE OR ITEM FEE — iNCiNEAn7oR � � <br /> WATEF CLOSETITOILET) 5 — <br /> UATHTU� <br /> I <br /> LAVATORY (W�15H BASINI <br /> SHOWEF —�— __ —�� <br /> KITCIiEN SINK & DISP. SU6 T0T/1L 5 �I <br /> DISHWASHER PERMIT 5� <br /> LAUN�RVTRAY TOTALfEE 5 �I - �� <br /> CLOTH@5 WASHER THIS PEHhiIT �ECOMES NVLL AND VOID IF WORK OR CONSTRUC- <br /> WMER HEATEfi TION AUTHORIZED IS NOT COMMLNCED WITHIN 120 DAVS, Oft IF <br /> VRINAL CONSTfiUCTION Ofi WOfiK IS $USPENDED O(i A9ANDONFD FOR A <br /> — PERIOD OF 120 Dl�YS AT ANY TIMC APTEq WOFK I$COt.1tdENCE�. <br /> DRINKING FOUNTAIN _ <br /> FLOOR-SINK OR DRNN I HEREUV CEflTIFY THAT I HAVE REA� ANO E%AMINED TNIS AP� <br /> - PLICATION AND KNOW THE SAME TD �E TqUE AND CORRECT. ALL <br /> VACUUM BREAKERS pqOVISIONS OF LAWS 1�N0 Of101NANCES GOVERNING THIS TYPE <br /> ROOF DRAINS-FAINLEAOERS OF WOFiK WILL B[ CUMPLIE� WITH WHETHEF SPECIFIED HEREIN <br /> SINK (SERVICF-6AR, ETC.) OR NOT, ThIE GRANTING OF A P[l1MIT OOES NOT PRESVME TO <br /> GIVE .\UTHORITV TO VIOLATE OR CARCEL THE PROVISIONS OF <br /> .__ AN� OTIiER STATE OP �OChL LAVJ REGULATING CONSTPUCTION <br /> OR TH[ PLViFOFMANCE OF CONSTRUCTION. <br /> SU� TOTAL <br /> PERMIT 5 �_ (y/1��T <br /> TOTAL FEE S <br /> __--_ X <br /> $IGNMUREOFCONTFiACTORORnUTH.AGENT DATE <br /> SIDE VAFD SET[7ACK STREET SE7pl�CY. REAR YAR�SET�AGY. PLI�N CHECK NUM�ER PLAN CHEGK FEE <br /> IFEE RECEIPT NO. <br /> �� USE ZONE LOT AREA VACl�NT SITE <br /> I �vEs ❑NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANC`�GROUN UN.IOS DWELLING � <br /> I <br /> I SI2f: OF OL�G. NO.OF STOFiIES �7A%.00C. IOAD �UILDING 5 I <br /> �— <br /> � PLUM�ING � <br /> FIRE 20NE Hl�SEMENT FIRESPRINKLERS � „r, <br /> i R`UUIfiED . .� <br /> ❑V[5 ❑NO ME�4p'dCAL <br /> I <br /> SPECIALCON�ITIONS�. OTHER � <br /> ____ PENEL7v SEC.3031a) � <br /> i -- .; 3:7 <br /> TOTAL <br /> — PERMIT VALIDATION <br /> WH@N PHONERI.'f VALIDMEO (IN THISSPACEI THIS IS VOUR PEIiMIT <br /> � <br /> f.CPlll�.lil1"..1,i11�T1111tY I'I!.'1':LIICfACI)fIV l.tl'1111VEI1fC1'il_�SLIAiIl:�9V <br /> I � n .. <br /> I I f <br /> 1 I <br />