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the Evergreen <br /> CITY OF CONSTRUCTiON c k,cLrett <br /> everett PERMIT <br /> CITY HALF 1191115 <br /> [VFRETI,WASHI010O1, <br /> R]01 <br /> DEPT BT CB44BY11Y BUILDING MECHANICAL PLUMBING <br /> o[vnovw[4T <br /> OWNER MAIL ADDRESS /iP PHONE .e <br /> ARCHITECT OR DESIGNER - MAIL ADDRESS PHONE LICENSE NO. <br /> GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE .. <br /> MECHANICAL CONTRACTOR MAIL ADDRESS PHONE—LICENSE NO. <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> LU <br /> O] <br /> PERMIT - CLASS OF WORK <br /> ❑BUILDING ❑PLUMBING m MECHANICAL drNZ <br /> EW ❑ADDITION ❑ALTERATION ❑REPAIR ~ <br /> VALUATION OF WORK <br /> f <br /> 00EM0LISH ❑FENCE ❑SIGN ❑SWIMMING DOLW <br /> DESCRIBE WORK <br /> 3° wlow= a <br /> 1973 <br /> PROPOSED USE <br /> MECHANICAL <br /> 1 VPh OF FUEL QOIL-------- 4 <br /> AT. LPO, ELE6. <br /> LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH GAS <br /> FOUR COPIES) <br /> LOT BLOCK—OF NO. TYPE OF EQUIPMENT FEE <br /> AIR COPED.UNITS-H.P.EA. f I <br /> REFRIGERATION UNITS-H.P. EA. <br /> BOILERS-H.P. EA. <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> FORCED AIR SYSTEMS-B.T.U. MEA. <br /> KhE 6W <br /> :JB ADDRESS V 2i � WALL HEATERS-B.T.U. M <br /> � UNIT HEATERS-B.T.U. M 1 <br /> PLUMBING EVAPORATIVE COOLERS <br /> CLOTHES DRYERS <br /> VENTII.ATION FAN <br /> RANGE HOOD I / <br /> NO. TYPE OF FIXTURE OR ITEM FEE AIR HANDLING UNIT- C.F.M. <br /> WATER CLOSET(TOILET S INCINERATOR <br /> BATHTUB <br /> LAVATORY(WASH BASIN) <br /> SHOWER <br /> KITCHEN SINK A DISP, SUB TOTAL S <br /> DISHWASHER <br /> LAUNDRY TRAY PERMIT f <br /> CLOTHES WASHER TOTAL FEE f <br /> WATER HEATER THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br /> 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 IS 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 /> SUB TOTAL <br /> PERMIT f <br /> TOTAL FEE f <br /> x <br /> SIGNATURE OF CONTRACTOR O RAUTH.AGENT DAT <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD TBACP PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> OYES ONO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP WO—OF DWELLING <br /> UNITS <br /> SIZE OF BLDG. NO-OF STORIES MAX.00C. LOAD BUILDING E <br /> I <br /> OA <br /> PLUMBING I <br /> IR ZON 1 S I KL RS <br /> REQUIRED <br /> DYES ONO MECHANICAL <br /> SPECIAL CONDITIONS: OTHER <br /> PENFI TY SEC. 203(s) I <br /> TOTAL <br /> 1 <br /> PERMIT VALIDATION <br /> — —'—' WHEN PROPERLY VALIDATED(IN THIS SPACEI THIS IS YOUR PFGMIT <br /> ATIICATIONACCEPTFURY 1PLANSCHFCKFORYFOAAMPOVFOBRUANCF wY. <br /> 2. a <br /> a <br />