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the Evergreen <br />CITY OF CONSTRUCTION vvereti <br />everett PERMIT <br />city NAIL 2SS IEl4 <br />EVERT R. WASNINGTGN <br />FSNI <br />DEPT Of Cammu"TY BUILDING MECHANICAL PLUMBING <br />DIVIERIPMENT <br />OWNER MAIL ADDRESS t11' PHONE <br />'�+. <br />ARCHITECT OR ESIGNER MAIL ADDRESS PHONE LICENSE NO <br />/� �ry <br />.lsl/ l <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />am <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />cc <br />W <br />m <br />PERMIT <br />CLASS OF WORK <br />BUILDING ❑PLUMBING MECHANICAL <br />❑ <br />❑NGW ADDITION �ALTE RATION DREPAIR <br />z <br />2 <br />VALUATION OF WORK <br />f <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />cr <br />LU <br />D9MW 9CRIBE3nOR rb to ftnq /i Ifto o <br />2287 <br />PROPOSED USE <br />Wn&akww <br />MECHANICAL <br />TYPIEOFFUEL ODIL HAT. ❑LPG. OELEC. <br />GAS <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />YOUR GGPIES) � vla a <br />LOT i BLOCK <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />—OF <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />- <br />BOILERS-H.P. EA. <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCCO AIR SYSTEMS-B.T.U. M EA. <br />I <br />JDFjE 5�5 <br />WALL HEATERS—B.T.U. M <br />;y <br />�{ 1 m 'A <br />UNIT HEATERS-B.T.U. M <br />I <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />1 <br />VENTILATION FAN <br />RANGEHOOD <br />I <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET (TOILET) <br />f <br />I <br />INCINERATOR <br />I <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />I <br />SHOWER <br />KITCHEN SINK IN DISP. <br />SUBTOTAL f <br />I <br />DISHWASHER <br />PERMIT f <br />LAUNDRY TRAY <br />TOTAL FEE f <br />I <br />CLOTHES WASHER <br />WATER HEATER <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />URINAL <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <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 />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />VACUUM BREAKERS <br />ROOF DRAINS-RAINLEAOERS <br />SINK (SERVICE -BAR ETC.) <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 />SUB TOTAL <br />PERMIT <br />f <br />TOTAL FEE <br />f <br />_ <br />3847 <br />SIGNA RE OFC T RACTOROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREETSETBACK <br />REARYAROSETRACK <br />PLAN CHECK NU ER <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. OCCU ANCY GROUP NO. OF DWELLING <br />UNITS I <br />p <br />S1ZE OF BLDG. NO. OF STORIES MAX. OCC. LOAD BUILDING f room 9 PC <br />PLUMBING I <br />I RIR Z�� HAS N FIRESPRINKLERS <br />REOUIRED <br />OYES ONO MECHANICAL 1 <br />SPECIAL CONDITI')NS: OTHER <br />PENELTY SEC. 303(a) I <br />TOT: '• 9 bo <br />PLHL,1 F VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />APPUCA71014 ACCFPTFDDY PIANSCHFCKEDaY M'NOVf110 .11ANGI Dv <br />Tow <br />1 <br />1 <br />