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the Evergreen <br /> CITY OF CONSTRUCTION everett <br /> everett PERMIT <br /> CITY NAU 159 FNS <br /> EVERETT.WUNINGTDN <br /> NMI <br /> DEPT aI COMMDNITY BUILDING MECHANICAL PLUMBING ,e <br /> DEYEIUPMENI <br /> OWNER MAIL ADDRESS ZIP PLJUNI <br /> aw!Ill a a 1 :i T:-Iqp vw am ste so if* 3551.0" 1957.761 <br /> ARCHITECT ORDESIGNER MAIL ADDRESS PHONE LICENSENO. <br /> GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br /> PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. cr <br /> LU <br /> m <br /> PERMIT CLASS OF WORK <br /> tBUILDING ❑PLUMBING (:]MECHANICAL z <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ~ <br /> VALUATION.gf.&PBE <br /> cr <br /> f •�^'�N/ ❑DEMOLISH ❑FENCE QSIGN ❑SWIMMING POOL W <br /> DESCRIBE WORK CL <br /> MM RM STAM O WM 1890 <br /> PROPOSED USE <br /> MECHANICAL <br /> FLEGAL OUR TYPE F UEL OIL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH OAST. 0 LPG. 0 ELIC <br /> LOT BLOCK—OF NO. TYPE OF EQUIPMENT F'L <br /> AIR COND.UNITS-H.P. EA. f I <br /> REFRIGERATION UNITS-H.P. EA, <br /> BOILERS-H.P. EA. <br /> GAS FIRED A.C.UNITS-TONNAGE EA. <br /> • _ rURCED AIR SYSTEMS-B.T.U. M EA. I <br /> JOB ADDRESSt • WALL HEATERS-B.T.U. M <br /> UNIT HEATERS-B.T.U. M I <br /> EVAPORATIVE COOLERS <br /> PLUMBING CLOTHES DRYERS I <br /> VENTILATION FAN <br /> RANGE HOOD I <br /> NO. TYPE OF FIXTURE OR ITEM FEE AIR HANDLING UNIT- C.F.M.- <br /> WATER CLOSET(TOILET) f INCINERATOR I <br /> BATHTUB <br /> LAVATORY(WASH BASIN) I <br /> SHOWER <br /> KITCHEN SINK 6 DISP. SUB TOTALS I <br /> DISHWASHER PERMIT f <br /> LAUNDRY TRAY <br /> TOTAL FEE f I <br /> CLOTHES WASHER TMS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC. <br /> WATER HEATER TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,CIA IF <br /> URINAL CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br /> DRINKING FOUNTAIN PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br /> R OOR-SINK OR DRAINI HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP <br /> VACUUM BREAKERS PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AL1 <br /> ROOF DRAINS-RAINLEADERSPROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br /> 61NK (SERVICE-BAR ETC.) OR NOT, TIIE 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 /> BUS TOTAL OR THE PER-ORMANCE OF CONSTRUCTION. <br /> PERMIT 6 <br /> TOTALFEE f <br /> x221291% <br /> v�DO <br /> SIGNATURE OF CONTRACTOROR AUTH.AGENT DATE <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACH PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USEZONE LOT AREA VACANT SITE <br /> OYES ONO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING <br /> UNITS I <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAO BUILDING f imago 3400 <br /> I <br /> FIR ON JUAbtmtN, FIRESPRINKLERS PLUMBING <br /> RrOUIRED - - <br /> OYES ONO MECHANICAL I <br /> SPECIAL CONDITIONSOTHER <br /> 1 <br /> T <br /> PENELTY SEC. SO]lal I <br /> TOTAL 000 <br /> PERMIT VALIDATION <br /> -- WHEN PROPERLY VALIDATED(IN THIS SPACE) TIVS IS YOUR PERMI T <br /> APPLICATION ACCEPt[DRY FIANSCR[CKFDPl APPPOVFOF <br /> y 1 <br /> D <br /> Y <br />