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. ..� .d �f�`ac.�. - <br />th^ Evergreen <br />CITY OF <br />everett <br />CILY HqLL 2538695 <br />EVEPELi.l945NINLi04 <br />95]]1 <br />�E�, oF_�....,�, r BUILDING <br />oevE�oFre�* <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL PLUMBING <br />everett <br />OWNER IAAILFDDRE55 ZIP PHONE <br />J.''. L�;�? ��aa u �.''I" ;�ra�e �3 � !��'S �'t6.��, <br />ARCHITECT OF DESIGNER MnIL A�DRESti PHONE LICENSE NO. <br />GENE9ALCONTRACTOR MAILAODRE55 PHONE LICENSENO. <br />� <br />MECHANICAL CONTRACTOR M.QIL ADDRESS PHONE UCENSE NO. <br />PLUMBING CONTRACTOF MAIL AODRESS PHONE LICENSE NO. � <br />W <br />m <br />PERMIT CLASSOF WORK � <br />z <br />� 6UILDING � PLVMBING ❑ MECHAM1ICAL X F- <br />❑NEW ❑AODITION `�JALTERATION ❑REPAIii � <br />VALUATION OF WORK � <br />5 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL a <br />�ESCRIBE WORK <br />�e0al.t aav t� roo�, ne�r roa: 2% 2 <br />PRGPOSEO USE <br />MECHANICAL <br />IEGAL DESCRIPTION OF PROPF.RTV ISNOW BELOW OR ATTACH TVPE OF FUEL �OIL ❑Gn5 �LPG. � EIEC. <br />FOURf�OPIE51 �. 11w 7M� we � <br />�.nT '� BLOCK_OF � ��� "^%^ ��� � �'' NO. TYPEOFEOUIPMENT FEE <br />AIN COND. UNITS-H.P. EA. 5 I <br />REFRIGERATION VNITS-H.P. EA. <br />DOILER$-M.P. EA. � <br />GAS FIRED A.C. UNITS-TONNFGE EA. <br />FOfiCED AIR SVSTEMS-6.T.U. M EA. I <br />JOB �Q(iES� � WALL HEATERS-B.?.U. M <br />�•�l UNIT HEATERS-B.T.U. M I <br />EVAPORAi'IVECOOLERS <br />PLUMBING CLOTHFSDRVEFS I <br />VENTIL4TION FAN <br />RANGEHODD 1 <br />NO. TVPE OF FIXTUflE OR ITEM FEE �+�R NANDI.ING VNIT- C.F.M. <br />WATER CLOSETITOILETI 5 WCINERATOR I <br />BATHTUB <br />_ �- <br />LAVATORVIWASHBASIN) I <br />SHOwER —�- <br />KITCHEN SINK & DISP. �_ SU8 TOTAL 5 � <br />DISHWASHER pERM1T 5 <br />LAUNDRI' iRAV �_ TOTAL FEE 5 � <br />CLOTHES WASHER �HIS PERMIT 13ECOMES NUI.L AN� VOiD IF WORK OR CONSTRUG <br />N'ATER HEATER TION AUTHORI2EG IS NOT COMMENCED WI�HIN 1�0 DAVS, 03 IF <br />VRINl�L CONSTRUCTION OR N'ORK IS SUSPENOED OF A9nY00NE0 FOR A <br />ORINKING FOUNTAIN PER�OD OF 12q DA�S AT ANY TIME AFTER WORK IS CO^dMENCED. <br />FLOOR-SINK OP DRAIN + I H[REBV CERTIFV THAT I HAVE FEAD AND E%AMINEO THIS AP- <br />VACUGM1I HREAKERS PUCAT�OIJ ANO KNOW THE SAME TO �E THUE AND CORRECT. ALL <br />POOF DfiAINS-RAINLEADERS �— PROVISIONS GF LAWS AND ORDINANCES GOVERNING THIS TVPE <br />OF VJOPK WILL BE COMPLIED NlITH WHETHER SPEpFIED HEf{E!N <br />SINK ISERVICE-BAR, ETC.1 �— OR NOT, THE GRnNTING OF A PEPMIT DOES NOT PR[SUME l0 <br />— - GIVE AUTHORITV TO VIOLATE OR CANCEL T11E PqOVISIONS OF <br />- � ANV OTHER STATE OR LOCAL LALN ftEGULHTII:G GONSTriUCfION <br />OR TME YERFORMANCE OF CONSTRUCTION. <br />SUBTOTAL <br />PERMIT S <br />TOTAL FEE S _ ��`v <br />x �r <br />SIGNI�TURE OF CONTRACTOR OR AUTM. f�GENI OATE <br />SIDEYAFDSETBACK STRE�TSET6ACK REARYARUSETDACKPLANCHECKNUM�ER PLANCHECKFEE <br />FEE IRECEIPTNO. <br />USE ZONC LOT AREA VACANT SITE I <br />❑vEs ❑NO FEES VALUATION FEE <br />TVPE OF CONST. UCCUPANCY GROUP NO.OF DWELLING <br />UNITS I <br />SI2E OF OLOG. NO.OF STOqIES MA%.00C. LOAD BUILDING 5 ���'�`n'N � <br />PLUMBING � <br />FIFE20NE BASEMENT FIRESPRINKLERS <br />Rf�UIRED <br />❑VES ❑NO MECHANICAL � <br />SPECIAL CCNDITIONS: OTMER � <br />PENELTV SEC.303fe1 � <br />TOTAL � <br />PERMIT VALIDATION <br />WHLN PRO�'ERLV VALIDATED I W 7HIS SPACEI THIS IS VpUR PERMIT <br />PPPLICAT�ONPCCEPTE�BY oL�1.�O�ELKE�M� AGPPOVE�FOFIIS.U•��OiBY <br />� <br />