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the Evergreen <br />CITY OF <br />everett <br />OlY "ALL 11f [Its <br />IVE A IF, W6NIMGI LW <br />SLAI <br />HIP) OPCOWWVIIIIT BUILDING <br />UVnorvul <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING �e <br />OWWLN�EEPRL y MAIL ADDRLSS ZIP PHONL <br />^ <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LIC NS NO. <br />L CwONT��RVyAACrCT��OR MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL NT� <br />ACTOR MAIL ADDRESS PHONE LICENSE NO. <br />MECHANICAL CONTRACTOR <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />m <br />PERMIT <br />(IBUILOING []PLUMBING []MECHANICAL <br />ClASB OF WORK <br />❑NEW ®ADDITION []ALTERATION ❑REPAIR <br />:3 <br />Z <br />F <br />� <br />VALUATION OF WORK <br />s <br />I —I <br />E IDEMOL ISH ❑FENCE. ❑SIGN ❑SWIMMING POOL <br />LU <br />UJ <br />_ n. <br />DESCRIBE WORK lr=o uvw mm m&u wd model <br />745 <br />PROPOSED USE <br />MECHANICAL <br />I YPL OF FUEL ❑OIL HAT. LPG. ELEC. <br />GAS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCK —OF VKW _ <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS H.P. EA. <br />S I _ <br />-- <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-H.P. EA. <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-O.T.U. M EA. <br />JOB ADDRESS <br />L3�V IIGMM no <br />WALL HEATERS-B.T.U. M <br />UNIT HEATERS-A.T.U. M <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />HANOEHOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />I <br />WATER CLOSET ITOILETI <br />ISIPICINE <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 6 DISP. <br />SUBTOTAL $ <br />I <br />_ <br />DISHWASHER <br />LAUNDRY TRAY <br />PERMIT S <br />TOTALFEE $ <br />I <br />CLOTHES WASHER <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 IZO DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />PLICATION AN' KNOW THE SAME TO BE TRUE AND CORRECT. ALI. <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 10 VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />X <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />_ <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEADERS <br />SINK (SERVICE -BAR ETC.) <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAL FEE <br />S <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />ST REET SETBACK <br />REAR YARD SETBACKPLAN <br />CHECK NUMBER <br />PLAN CHECK FEE <br />PT NO. <br />FEE stow <br />�iP�F <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />[]YES []NO <br />FEES <br />VALUATION <br />FEE _ <br />1 YPE OF CONSi. <br />OCCUPANCY GROUP <br />-DWELLING <br />WO <br />_ <br />1MM <br />BUILDING <br />��,,//�����//yy\\ <br />$ mow <br />he 1w <br />912E OF SLOG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />-FIR ON <br />BASE <br />RE�UIREDKL <br />❑YES ❑NO <br />MECHANICAL <br />---- <br />) <br />SPECIAL CONDITIONS: _ <br />OTHER <br />1 <br />I <br />- <br />PENELTY <br />SEC. 303(111 <br />) <br />TOTAL <br />1 <br />lab <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN I HIS SPACE) THIS IS YOUR PERMIT <br />A <br />AIWIICATIONACCEPTEDBY <br />d a <br />PLANSCHICAEOPr <br />1e. o. <br />AAADVFDT �110E BY <br />-� <br />