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the Evergreen <br /> CITY DF CONSTRUCTION everett <br /> everett PERMIT <br /> DIV HAII 299211N <br /> r V(IRTI WASHINVON <br /> RNI <br /> ORI OFON?YZ1Y <br /> o[Vf BUILDING MECHANICAL PLUMBING .e <br /> vftOlMp <br /> OWNER MAIL ADDRESS PHONE <br /> ^TrUM LlMI bit (OW Sb S(2.s 355-M �MllM�r <br /> ARCHITECT OR DESIGNER MAIL ADDRESSPHO NF__ LICENSE NO. / <br /> GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> Irm <br /> MECHANICAL CONTRACTOR MAIL ADDRESS PHONC LICENSE NO. <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. w <br /> �• W <br /> uL'aM m <br /> PERMIT CLASS OF WORK <br /> % Z <br /> BUILDING ❑PLUMBING ❑MEC)/ANICAL ADDITION L�ADDITION ❑ALTERATION ❑REPAIR <br /> VALUATION O ��N• q cc�^+V�N/J <br /> [I DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL Ul <br /> f _ <br /> DESCRIBE WORK •rre-eNws � ISA3 <br /> PROPOSED USE MECHANICAL L <br /> 1 YPE OF FUEL OIL NAT. LPG. OELEC. <br /> FOUR Cfi11PTIONO PROPE RTM• •�Q,�LOW MSA)J"Il 6A5 <br /> LOT At OCK_OF---- `�I[PI ��7jP� ia74 NO. TYPE OF H.P. EA. FEE <br /> AIR COND.UNITS-H.P. EA. S I <br /> REFRIGERATION UNITS-H.P. EA. <br /> BOILERS-H.P. EA. 1 <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> _ FORCED AIR SYSTEMS-B.T.U. M EA. 1 <br /> JOB ADDRESS 1�I- L', t ly - WALL HEATERS-B.T.U. M <br /> 4W �M UNIT HEATERS-B.T.U. M 1 <br /> EVAPORATIVE COOLERS <br /> PLUMBING CLOTHES DRYERS 1 <br /> VENTILATION FAN <br /> RANGE HOOD I <br /> N TYPE OF FIXTURE OR ITEM FEE AIR HANDLING UNIT- C.F.M. <br /> WATER CLOSET(TOILET) S INCINERATOR I <br /> BATHTUB <br /> _ LAVATORY(WASH BASIN) II <br /> SHOWER <br /> KITCHEN SINK d DISP. SUB 1 OTAL f I <br /> _ DISHWASHER PERMIT S <br /> LAUNDRY TRAY TOTALFEE S 1 <br /> CLOTHES WASHER THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC. <br /> WATER HEATER TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF <br /> URINAL CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br /> _ DRINKING FOUNTAIN PERIOD OF 120 DAYS AT ANY TIME AFTER WORK 19 COMMENCED. <br /> _ FLOOR-SINK OR DRAIN 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> VACUUM BREAKERS PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ROOF DRAINS-RAINLEADERS + PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> _ OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> SINK (SERVICE-BAR ETC.) 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 /> SUBTOTAL <br /> - PERMIT S - <br /> TOTALFEE f <br /> X <br /> SIGNATURE OF CONTRACTOROR RUTH.AGENT DATE <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD GETBACK PLANC HEC NUMBER PSL IAfN CNECK FEE <br /> FEE ��p RECI . <br /> USE ZONE LOT AREA VACANT SITE �i� <br /> ❑YES []NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING <br /> UNITS <br /> mow <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAD BUILDING S <br /> PLUMBING I <br /> IR T RI -I---- <br /> REQUIRED KS <br /> ❑YES ONO MECHANICAL I <br /> SPECIAL CONDITIONS: OTHER 1 <br /> _ 1 <br /> PENELTV SEC.303(A) I <br /> -- TOTAL 1 <br /> PERMIT VALIDATION <br /> WHEN PRUPERLY VALIDATED ON THIS SPACEI THIS IS YOUR PERMIT <br /> AMLICA710N ACCEFIFD UY PLANS DIFCNED WY AMROVU WJAWF BY. <br />