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the Evergreen <br />CITY OF CONSTRUCTION everell <br />everett PERMIT <br />C,11 HAIL ASEUS <br />EV[NETT. WASHINGTON <br />SIN, <br />OEPT OF COMMON", BUILDING MECHANICAL PLUMBING <br />011I11PMENT <br />OWNER MAIL ADDRESS ; u' PHpONL <br />LrkW 7• C' ^RG Pe Ga SA •ym am, t7i; 9HOD6 F F 7'yN`� <br />l '2i ;=1L <br />ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO <br />GENERAL CONTRACTOR MAIL ADORES£ PHONE LICE NO <br />D A G CDtt "" « �! CC of ^.lu�'L <br />) <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />t4?91 <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />W <br />PERMIT <br />CLASS OF WORK <br />Z <br />BUILDING [IPLUMI NO [MECHANICAL <br />NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />S <br />DESCRIBE WORK - <br />COMM" Si.%w mats tiP't mo l <br />1776 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL []OIL NAT. LPG. ELEC. <br />GAS <br />LEGAL 0ESC A I PT ION OF PROPERTY IS HOW BELOW OR ATTACH <br />FOUR COp I c4�m Q, <br />LOT BLOCK_OF <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />- - <br />S I <br />AIR COINED. UNITS—H.P. EA. <br />1 <br />REFq IGERATION UNITS-H, P. EA. <br />BOILERS-1/,P. EA. <br />I <br />-- <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />I <br />FORCED AIR SYSTEMS-B.T.U. EVE EA. <br />I <br />JOB ADDRESS e <br />N <br />`� o <br />WALL HEATERS-S.T.U. M <br />I <br />UNIT HEATERS-B.T.U, M <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTI LATION FAN <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />T <br />- <br />I <br />N <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />WATERCLOSETITOILETI <br />f <br />INCINERATOR <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />_ <br />SHOWER <br />KITCHEN SINK & DISP. <br />SUB TOTAL f <br />__(-- <br />I <br />DISHWASHER <br />PERMIT f <br />LAUNDRY TRAY <br />- <br />TOTAL FEE S <br />I _ <br />I <br />CLOTHES WASHER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITIIIN 120 DAYS, OR IF <br />WATER NEATER <br />URINAL <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 110 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />1 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 />VACUUM BREAKERS <br />-- <br />ROOF DRAINS-RAINLEADERS <br />-�— <br />SINK (SERVICE -BAR ETC.) <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 STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SUBTOTAL <br />PERMIT <br />f <br />TOTALFGE <br />SIGNATURE OF CONTRACTOROR AUTH, ADEN DATE <br />SIDE Y*IDSETBACK <br />STREET UIBACK <br />REAP Y=gSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />iA <br />'�P <br />FEE n.M RECF�IP=flf�. <br />W �7j�P, <br />USE jP� <br />LOT AREA <br />VACANT SITE <br />f1"M <br />)]YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. OCCUPANCY GROUP NO Os DWEtING NiT <br />SIZE OF SLOG. NO. OF STORIES MAX. OCC. LOAD BUILDING f 3500mom 'o <br />PLUMBING <br />FIRE ONE BAS T I E RI K -R- <br />FO1� <br />YES L'NO MECHANICAL I <br />3 DYES <br />SPECIAL CONDITIONS: OTHER <br />I <br />----- PENELTY SEC. 000 Ia1 I <br />TOTAL I <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PE RMIT <br />APPLICATIONAMIPUI)PY PIAMCHECKIOWY APPPOVIOFO ISGU46FSY <br />0 <br />