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NIP Evergreen <br />CITY OF <br />everett <br />I.tY NAtt IS48885 <br />EVE RI IL NASMNOON <br />SROI <br />otrt of EOKBDNIt' BUILDING <br />o1VHoPXIet <br />CONSTRUCTION <br />PERMIT <br />MECI-iANICAL <br />everell <br />LePLUMBING <br />OWNERMTo ��AIL AODIIL55 Ill. PIIUNE <br />S��N� �5�q <br />ARCHITECT OR D SIGNER -- MAIL ADDRESS PI/DRY LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />��S�N� <br />PERMIT - --- _ ---- - - CLASS OF WORK <br />I�,,11�� <br />BUILDING & PLUMBING ❑ MECHANICAL ��55 <br />�I NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />W <br />Z) <br />Z <br />H <br />� <br />VALUATION OF WORKcc <br />f <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOI <br />LL <br />DESCRIBE WORK y4lawtl(f <br />1002 <br />PROPOSED USE <br />_ <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR ESI P •q <br />LOT BLOCK OF FM1S' .. <br />MECHANICAL <br />TY EOFFUEL OIL (7[NAT. LPG. ❑EI.EC <br />GAB <br />NO. <br />TYPE OF EQUIPMENT <br />Eee <br />AIR COND. UNITS-H.P. EA. <br />_ _ <br />S <br />REFRIGERATION UNITS-H.P. EA. <br />1 <br />BOILERS-H.P. EA. <br />I <br />_ <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />1 <br />JOB ADDRESS • `- 41 n %` p' <br />103 "0 <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGE NOOO <br />I <br />O. <br />TVPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />AL <br />WATER CLOSET(TOILETI <br />f <br />INCINERATOR <br />I <br />BATHTUB <br />LAVATORY WASH BASIN) <br />I <br />SHOWER <br />SUB TOTAL f <br />I <br />KITCHEN SINK & DISP, <br />_ <br />_ <br />DISHWASHER <br />_ <br />PERMIT S <br />LAUNDRY TRAY <br />TOTAL FEE f <br />I <br />CLOTHES WASHER <br />_ <br />WATER HEATER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />I$ON AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 1Z0 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 />RIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />NY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />JR THE PERFORMANCE OF CONSTRUCTION. <br />u <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SI"K (SERVICE-RAR. ETC.) <br />SUBTOTAL <br />_ PERMIT <br />S <br />TOTAL FEE <br />S <br />SIGNATURE OF CONTnACTOROR AUTH. AGENT DATE <br />PLANCIIECKNUMBER PLAN CHECK FEE <br />BIL " FEEtw40 RECEIPT NO. <br />STtS7LP W <br />SIDE YARD SETBACK <br />54 <br />STREET SETBACK <br />no <br />REAR YARDSETBAC <br />20' <br />USLZQNE <br />'%a <br />LOT AREA <br />VACANT SITE <br />RVES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF O ELLING <br />UNITS <br />I <br />2m bo <br />--- <br />I <br />I <br />BUILDING <br />SWOW <br />SIZ ' OF SLDG. <br />NO. OF SjfRIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIR O <br />BAS <br />WIN <br />IR RINK S <br />Rr OUtRED <br />DYES NO <br />MECHANICAL <br />SPECIAL CONDITIONS: <br />OTHER <br />PENELTY <br />SEC. 007(B) <br />TOTAL <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS (OUR PERMIT <br />Q <br />AA LICATI]QN�ACCEFTEDBY. <br />�T � <br />PLANS WECKE BY AM{P.OVIPIO <br />� a <br />/�S�,StIP11Cl BY. <br />N C�/a• C� <br />