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the Evergreen CONSTRUCTION everen <br />CITY OF PERMIT <br />everett <br />CITY HALL 2S9874S <br />EVER ETT, WA 98201 COMBINATION a BUILDING a ;MECHANICAL • PLUMBING e, <br />OWNER ank C Y�n RLc10M% t]URtiS - ZIP 355axBPIONE <br />kilo Xxx kk <br />ARCl11T LC (H DESIGNER - MAIL AODPESS PHONE LICENSL NO. <br />RR <br />3 <br />1 <br />GENERAL CONT PACT OR PHONE LICENSE NO, <br />Everett Builders 5606 Evergreen Way 353-7161 223-01-EV ER EB 301 <br />Z <br />PH C' <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />3 <br />Q7 <br />a <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PERMIT <br />❑COMBINATION <br />QBUILOING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK. <br />❑NEW ❑ADDITION ❑ALTERMION ❑REPAID <br />VALUATION OF WORK <br />§ XERRxRRX 1425.00 ❑Oi MOt_ISH 1w NCE ❑^.IGN ❑SWIMMING POD) <br />DESCRIBE WORK - <br />XRXXRRfXkRIHI*AXiwxx9I4kjmXA fence 6' side and rear <br />PROPOSED USE <br />MECHANICAL. <br />TYPE Of 1 NI 141, v <br />_ ❑GAS ❑ELEC. <br />NO. TYPE OF EQUIPMENT FEE <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH) <br />FOUR COPIES) <br />LOT 29 BLOCK —OF Highland View <br />AIR CONO. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS H.P. EA, <br />BOILERS H.P.EA. <br />FORCED AIR SYSTEMS-O.T.U. MEA. <br />'OB ADDRESS <br />1310 74th Street S.E. <br />SPACE A WALL HEATERS - B.T.U. <br />_ <br />UNIT HEATERS R.T.U. <br />I <br />PLUMBING <br />-- <br />EVAP013ATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION PAN <br />_ - <br />_ <br />_ _ <br />RANGE HOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M.- <br />BATH TUBS <br />-- <br />-- - ----- ------ <br />WATFR 11FATER _ <br />FAC BUILT I IRFPLACE A CHIMNEY <br />GAS. SYSTEM NO OP OUTLETS <br />sUn TOTAL S <br />CLOTHES WASHER <br />DISH WASHERS <br />I <br />DRINKING FOUNTAINS <br />, <br />FLOOR DRAINS <br />KITCHEN SINKS A DISIP <br />1 <br />BAR SINKS <br />PERMIT S <br />ROOF DRAINS - RAIN LEADERS <br />TOTALF'EE $ <br />I <br />SHOWER BATHS <br />_ <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUE <br />IION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED On ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTEn WORK ISCOMMENCED <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS A' <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORF,ECT. A' <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYI . <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 01 <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />x <br />_ <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />- <br />URINALS <br />WATER CLOSETS <br />WATER HEATERS - ELECTRIC <br />_ <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />— <br />-- <br />1 <br />_ <br />1 <br />_--- <br />SUB TOTAL <br />PERMIT <br />S <br />TFEE <br />S <br />WATER <br />SERVICE 512E BLDG. SUPPLY <br />SIZE <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />:IDE YARD SETBACK <br />STREETSETBACK REARYARDSETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />FEE RECEIPT NO, <br />USE ZONE <br />LOTAREA VACANT <br />SITE <br />[]YES ONO <br />FEES <br />VALUATION <br />FEE <br />1 YPE OF CONST. <br />OCCUPANCY GROUP NO. <br />UNITS <br />OF DWELLING <br />BUILDING <br />1 <br />15 I GG <br />it <br />I <br />1 <br />I <br />pII� <br />§ 142xxxexx <br />'.IZE OF BLDG. <br />NO. OF STORIES MAX.00C. <br />LOAD <br />PLUMBING <br />IIRE ONE <br />flA N` <br />REOUIRE <br />SPKR. <br />LD <br />❑VCS ONO <br />MECHANICAL <br />'1'ECIAL CONDITIONS: <br />— — <br />OTHER <br />----- <br />PFNALTY <br />TOTAL <br />SEC. 303(a) <br />-- <br />- - <br />-- <br />PERMIT VALIDATION <br />WIZEN PnOPE RI Y V AI IDAT ED IIN 71115 EI'ACLI T IIIS IS YOU%PERAl1i <br />THANK YOI<o <br />JIM 1 <br />, WAnary ACU P❑II HY PIAN56111LMONY AMROW O]ON1:•;nn'x <br />----� -- eb <br />I <br />