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the Ew..rgreen <br />CITY OF <br />everett <br />CITY NALS 15E1R5 <br />EYE 'ITT, WASHINGTON <br />NMI <br />DEPT OF COMMUNITY BUILDING <br />D(V(LDPMENI <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />OWN'R MAIL ADDRESS <br />vmwwm ; Vi G1u0 ate <br />ARCHITECT OR DESIGNER-- - MAIL ADDRESS <br />GENERAL CONTRACTOR MAIL ADDRESS <br />am wM vt+T r" !Y <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />PLUMBING CONTRACTOR MAIL ADDRESS <br />!GRIT Dow "Am" <br />PERMIT CLASS OF WORK <br />[I BUILDING :]PLUMBING (I MECHANICAL &� <br />tI NEW <br />VALUATION OF WORK <br />$ <br />❑ DEMOLISH <br />DESCRIBE WORK <br />PROPOSED USE <br />FOUR DESC IIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />LOT BLOCK —OF <br />[�_ <br />JOB ADDRESS ph MINI <br />i�F� N <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATER CLOSET (TOILET) <br />$ <br />BATHTUB <br />LAVATORY (WASH SAS'N) <br />SHOWER <br />KITCHEN SINK Be DISP. <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHESWASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKS AS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE- BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />S <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK I <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES []NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP PIO.OF <br />W LLINO <br />UNITS <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />FIRE ZON" <br />BAS MERr— FIRESPRINKLEAS <br />RTOUI[IED <br />DYES []NO <br />SPECIAL CONDITIONS. <br />AMIICA71ON ACCEPTED BY <br />PUNS CN[CKFO BY AMMO <br />ISMIAN[E pY <br />a <br />PLUMBING <br />El ADDITION ❑ALTERATION ❑REPAIR <br />❑FENCE ❑SIGN ❑SWIMMING POOL <br />MECHANICAL <br />RATION UNITS-M.P. <br />WALL <br />UNIT <br />AIR HANDLING UNIT - <br />INCINERATOR <br />everett <br />e. <br />atow <br />526 <br />SUB TOTAL $ I <br />PERMIT S �— <br />TOTALFEE $ <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATP OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />is <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />'LAN CHECK NUMBER PLAN CHECK FEE <br />FEE IRECEIPT NO. <br />FEES I VALUATION I FEE <br />[UILDINO <br />'LUMBING <br />I <br />/I <br />AECHANICAL <br />7THER <br />'ENELTY <br />SEC. 3071d <br />T <br />I <br />TOTAL <br />h <br />'ERMIT VALIDATION <br />VNEN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT <br />