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the Evergreen <br /> CITY OV CONSTRUCTION everett <br /> everett PERMIT <br /> CITY HAIL rSSFMs <br /> tvIRETT.Wr3NINOTON <br /> Rr4T BUILDING MECHANICAL PLUMBING <br /> UVC Or COMMUNITY <br /> D[vllnrYl Yl <br /> OWNER MAIL ADDIIISS JII' PHONE <br /> IIIm� auto 14,4w" , 314 om 9103 900% <br /> ARCHITECT OR DESIGNER MAIL ADDRESS PlIMN-F LICENSE NU. <br /> GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. LU <br /> W <br /> ft"w Is P.Q. >�t 86r 9Q9 Q► _ co <br /> PERMIT CLASS OF WORK <br /> Z <br /> ❑BUILDING ❑PLUMBING ❑MEC/IANICAL ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ~ <br /> VALUATION OF WORK O: <br /> ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL W <br /> f - - - a <br /> DESCRIBE WORK 847 <br /> PROPOSED USE MECHANICAL <br /> TYPE OF FUEL ❑OILNAT. LPG. ❑ELEC. <br /> LEGAL DESCRIPTION OF PROPERTY(SHUW BELOW OR ATTACH GAS <br /> FOUR COPIES( <br /> NO. TYPE OF EQUIPMENT FEE <br /> LOT BLOCK—OF— AIR COND.UNITS-M.P.EA. S I <br /> REFRIGERATION UNITS-H.P.EA. <br /> _ BOILERS-H.P.EA. 1 <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> FORCED AIR SYSTEMS-B.T.U. M EA. I __ <br /> JOB ADU{TE$5 WALL HEATERS-B.T.U. M — - -- <br /> iA/f+- UNIT HEATERS-B.T.U. M 1 <br /> EVAPORATIVE COOLERS <br /> PLUMBING CLOTHES DRYERS I <br /> VENTILATION FAN <br /> RANGE HOOD I 1 <br /> NO. TYPE OF FIXTURE OR ITE F AIR HANDLING UNIT- C.F.M. <br /> WATER CLOSET(TOILET) f INCINERATOR I <br /> BATHTUB Ll <br /> LAVATORY(WASH BASIN) <br /> SHOWER <br /> KITCHEN SINK b DISP, SUB TOTAL f I <br /> DISHWASHER PERMIT f <br /> LAUNDRY TRAY TOTAL FEE f I <br /> CLOTHES WASHER THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br /> WATER HEATER owTION AUTHORIZED IS NOT COMMENCED WITHIN 170 DAYS,OR IF <br /> URINAL CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br /> DRINKING FOUNTAIN PERIOD OF 170 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br /> _ FLOOR-SINK OR DRAIN I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br /> VACUUM BREAKERS PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS Of LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> ROOF DRAINS-RAINLEADERS OF WORK WILL BE COMPLIED WIT(/WHETHER SPECIFIED HEREIN <br /> BINK (SERVICE-BAR ETC.) OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUT14ORITY 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 f <br /> TOTALFEF. S <br /> X <br /> SIGNATURE OF CONTRACTOR OR AUTH,AGENT DATE <br /> SIDE YARD SETBACK STREET SETRACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> OYES ONO FEES VALUATION FEE _ <br /> SYFE OF CONST. OCCUPANCY GROUP _NO.OF DWELLING 1 <br /> UNITS <br /> SIZE OF BLDG. NO.OF STORIES VAX.OCC. LOAD BUILDING f <br /> I��FFff�� <br /> PLUMBING 33100 <br /> 1-IRE ZONE BASEVE0 RINKL — <br /> REOUIRED MECHANICAL I <br /> OYES ONO <br /> SPECIAL CONDITIONS'. OTHER <br /> I <br /> _ PENELTY SEC.70714 �NrN <br /> TOTAL 23:00 <br /> ----- PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> APJILATION•cCWTIU BY PLANSCHFCKFD BY •MPDVfD fO ISSU�NCF BY. <br /> 0 <br />