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the Evergreen <br />CITY OF CONSTRUCTION everett <br />everett PERMIT <br />CITY MAIL AT ENS <br />EVERETT. WASHINGTON <br />"JOE <br />O[R. ORCOXNDNITY 0[VGOW[Ni BUILDING MECHANICAL PLUMBING <br />OWNER MAIL ADDRESS ZIP PHONE <br />^ <br />L ••`` / <br />vwm 74LJ"76 <br />ARCHITECT OR DESIGNER MAIL ADDRESS - PHONE LICENSE NO. <br />GENERAL CONTRACTOR N MAIL ADDRESS PHONE LICENSE NO. <br />"'+ Vwyq <br />MECHANICAL CONTRACTOR MAIL ADDRESS - - PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO cr <br />W <br />coI I'm name <br />PERMIT CLASS OF WORK <br />P.Z <br />ABUILOINO CALUMBING MECHANICAL [[�� <br />KNEW []ADDITION ❑ALTERATION ❑REPAIR � <br />-- <br />VALUATION OF WORK <br />S 32 <br />❑DEMOLISH []FENCE ❑fIGN ❑SWIMMING POOL <br />cc <br />d <br />DESCRIBE WORK <br />C, 725M , .iIIT 7 Shw= iX M .= <br />1 S 7 $ <br />PROPOSED USE <br />MECHANICAL <br />HAT LPG. ❑ELEC. <br />TY EOF FUEL ❑OIL . ❑UAL <br />GAS <br />DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR <br />FOUR OOPIESI <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />LOT i BLOCK —OF— __ <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-H.P. EA. <br />�— <br />BOILERS-H.P. EA. <br />GAS FIRED A,C, UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-e.T.U. M EA. <br />I <br />JOB ADDRESSw may' <br />�A7� NMP� <br />_ <br />WALL HEATERS-B.T.U. M <br />UNIT ))EATERS-O.T.U. M <br />PLUMBING <br />EVAPORATIVE COOLERS <br />CLOTHES DRYCRS <br />I <br />VENTILATION FAN <br />RANOEHOOD <br />I <br />1 <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSET TOILET) <br />S <br />INCINERATOR <br />I <br />BATHTUB <br />1 __ <br />JJJ <br />LAVATORY WASH BASINI <br />SHOWER <br />-- <br />KITCHEN SINK 6 DISP. <br />SUBTOTAL S <br />DISHWASHER <br />PERMIT f <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />TOTAL FEE f <br />I <br />WATER HEATER <br />THIS PERMIT SECOM iS NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED I NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />URINAL <br />PERIOD OF 170 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP <br />VACUUM BREAKERS <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 WHETHFR SPECIFIED HEREIN <br />OR NOT, THE ORANTIVG OF A PERMIT DOES NOT PRESUME TO <br />_ <br />ROOF DRAINS-RAINLE qDE RB <br />SINK (SERVICE -BAR, ETC.) <br />�— <br />GIVE AUTHORITY TO IIOLATE OR CANCEL THE PROVISIONS OF <br />- <br />ANY OTHER STATE C R LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PEPFORMAK(,E OF CONSTRUCTION, <br />SUB TOTAL <br />PERMIT <br />f <br />TOTALFEE <br />SIGNATURE OF CONTRACTOROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />PEAR YARDSETRACP <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />�f" <br />FEE �. AM RECEIPT NO. <br />[E� <br />J <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />I' <br />YPE OF CONST. OCCUPA CY GROUP NO.OF DWELLING <br />UNITS I <br />SIZE OF BLDG. NO. OF STORIES MAX. OCC. LOAD BUILDING S iiM� W <br />PLUMBING 271 yy <br />I -IRE 4UNt uAuEMENi RINKL <br />REQUIRED - <br />❑YES ❑NO MECHANICAL TIW <br />SPECIAL CONDITIONS! OTHER <br />- -- PFNELTY SEC. 3031AI I <br />TOTAL_ - <br />I <br />PERMIT VALIDATION <br />- WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMI7 <br />"IN RATION ACCEPTED BY PLANS (YIECk[O RY AHPPOVI Ojp ISSUAK[BY <br />lY_ AN_ <br />1 <br />I <br />O <br />