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the Evergreen <br />CITY OF CONSTRUCTION everett <br />everett PERMIT <br />Illy NJli RNFus <br />L VF III IT WNSHINGION <br />11m1 <br />BFPT UI I°BNUNITy BUILDING MECHANICAL PLUMBING <br />FIVHBPVINT <br />OWNER MAII. ADDRESS ZIP PHONE <br />mm t. aawlm= 1t70Wi IYl?= 714 UV 3TF v _3 3I11061' Tr <br />ARCHITECTOR DESIGNER MAIL ADDRESS PHONE LICE. ISE NO. <br />GEI,fER�LOtST�FT;fi r�l AOO RESS P�ONL r £FD <br />ff <br />MECHANICAL CONTRACTOR MAII n0On11SS PHONE I. 1CCENSE NT <br />cc <br />W <br />m <br />PLUMBING CONTRACTOR MAT. ADDLS RS PIIONL LICENSE NO. <br />PERMIT CLASS OF WORK <br />z <br />s � <br />(JBUILOINC ❑PLUMOING ❑MECHANICAL ICI NEW ❑ADDITION ❑ALTERATION ❑REPAH+ <br />~ <br />VAWATI DOS ��i� <br />�yM/fAli{I <br />❑DEMOLISH []FENCE []SIGN []SWIMMING POOL <br />LU <br />G. <br />DESCRIBE WORK y� <br />•/NK�)Y+M•a <br />402 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL OOIL ❑GNAT.AS LPG. �ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW RF.LOW OR ATTACH <br />FOUR COPIES( Lus Pr t "Ve D <br />NO. <br />TYPEEQUIPMENT <br />FEE <br />LOT BLOCK-YG OF <br />AIR COND. UNITS-H.P. EA. <br />S I <br />y •� Mel dFL n a v <br />REFRIGLFINTION UNITS-H.P. EA. <br />BOILERS H.P. EA. <br />I <br />�f �P A <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />_ <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />--T <br />JOB ADDRESS /FM/I a k MY M <br />WALL HEATERS-B.T.U. M <br />-- <br />UNIT HEATERS- B.T.U. M <br />I _ <br />T _ <br />EVAPORATIVE COOLERS <br />PLUMBING <br />_ <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />_ <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />�— <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />INCINERATOR <br />1 <br />WATER CLOSET(TOILET) _ <br />S <br />- <br />_ <br />BATHTUB <br />- <br />LAVATORY (WASH BASIN) <br />I - <br />SHOWER <br />i- <br />-. <br />_ <br />KITCHEN SINK 6 DISP. <br />SUB TOTAL $ <br />I <br />DISHWASHER <br />PERMIT S <br />_ <br />LAUNDRY TRAY <br />_ <br />TOTAL FEE <br />CL•)THES WASHER <br />THIS PERMIT BECOMES NULL ONO VOID IF WORK On CONSTRUC <br />HATER HEATER <br />TION AUTHORIZED IS NOT CCAIMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK 15 SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />I HEREBY CERTIFY THAT 1 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 />_ <br />UR:FJAI. <br />ORIN_KH_IU FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACU-IM BREAKERS <br />—�- <br />_ <br />ROOF (RAINS-RAINLEADERS <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIV- AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />_ <br />SINK (SERVICE -BAR, ETC.1 <br />-�— <br />— <br />ANY OTHER STATE OR LOCAL -AW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SUB TOTAL <br />PERMIT <br />f <br />TOTAL FEE S <br />x <br />_ _ <br />SIGNATURE CV CC' I RACTOROR AUTH. AGENT Uill1 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />HEAR YAFIDSIETDACK <br />PLAN CHECK NUMBER <br />PLAN CHECK IEL <br />764Mlow <br />FEE � RECE <br />USE 2 NNE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. OCCUPANCY GROUP NO.DWELLING <br />UNITS <br />lho//yyyNFl�N ��yNF�� -�//��//�� <br />51 ZE OF BLDG. NO. OF STO7J 5 Mf A OCC. LOAD BUILDING SvcwlmNFNP �1t Im <br />- <br />_ <br />PLUMBING <br />F WE roNE BASE ME NT AFOUIREDK R <br />❑YES ONO MECHANICAL <br />SPECIAL CONDITIONS OTHER <br />-- T <br />PENELTY SEC 30. I:: 1 <br />TOTAL <br />PERMIT VALIDATION <br />- WHEN PROPERLY VALIDATED (IN THISSPACEI THIS IS YOUR PERMIT <br />n PPLOCATION ACCFP1FD B77FU Hr ♦PI'BG 1f0 FO ISBUAMCF BY <br />0� <br />G <br />