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the Evergreen <br />CITY OF <br />everett <br />CITY MAIL TSB UIS <br />i VI BF IT. WASHIN GIDN <br />•ENI <br />"'P' Df CommuNity <br />DEVROPYEMI BUI'-DING <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />jevorutt <br />PLUMBING <br />ri <br />mwlL. quo RE55 <br />ZIP PHONE <br />'/BW <br />077 <br />ARCHITECTORUESIONER MAIL ADDRESS PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />K4CHANICAL CONTRACTOR <br />1i:1l M PART E'ArM <br />MAIL ADDRESS <br />PHONE LICENSE NO. <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />PHONE LICENSE NO. <br />cc <br />W <br />m <br />'ERMIT <br />❑ BUILDING ❑ PLUM81NO (MECHANICAL <br />CLASS OF WORK <br />�NEW <br />❑ADDITION ❑ALTERATION ❑REPAIR <br />Z <br />F- <br />W <br />VALUATION OF WORKCr <br />: <br />DESCRIBE WORK <br />-- <br />❑DEMOLISH <br />❑FENCE ❑SIGN ❑SWIMMING POOL <br />1906 <br />PROPOSED USE <br />MECHANICAL <br />1 LGR OESC RIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />I UUR COPIESI <br />LOT BLOCK <br />I YPE Of FUEL ❑OIL ONAAS. LPG. ❑ELEC. <br />NO• <br />TYPE OF EQUIPMENT <br />FEE <br />—OF <br />AIR COND. UNITS-H.P. EA. <br />S I <br />REFRIGERATION UNITS-M.P. EA. <br />_ <br />BOILERS-H.P. EA. <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-B.T.U. M EA. <br />JOB ADDRESS 38M W R� .yE �y <br />'"`LNl7 P« <br />PLUMBING <br />WALL HEATERS-B.T.U. M <br />I <br />UNIT HEATERS-B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />WATER CLOSETITDILETI <br />3 <br />INCINERATOR <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 CHIP. <br />SUBTOTAL $ <br />I <br />OISHWASHER <br />LAUNDRY TRAY <br />PERMIT MIT <br />CLOTHES WASHER <br />TOTAL FEE $ <br />f1 <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 />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />1 HEREBY CERTIFY THAT I 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 ODES NOT PRESUME TO <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 />tv do*am <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS -RAIN LEADERS <br />SINK (SERVICE -BAR ETC.) <br />SUB TOTAL <br />PERMIT { <br />TOTAL FEE { <br />_ <br />SIGNATUREOFCONTRACTORORAUTHAGENT DATE <br />SIDE YARD SETBACK <br />STREETSETBACK <br />REAR VARD SETBACP <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />FEE <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />TYPE OF CONST. <br />LOT AREA <br />OCCUPANCY GROUP <br />VACANT SITE <br />DYES ❑Nu <br />NO.OF DWELLING <br />UNITS <br />FEES <br />VALUATION <br />FEE <br />SIZE OF SLOG, <br />NO. OF STORIES <br />VAX- 000. LOAD <br />BUILDING <br />S <br />1 <br />I <br />PLUMBING <br />1 <br />FIR ONE <br />BAS T <br />11 I (L <br />A FOUI REO <br />❑YES ❑NO <br />MECHANICAL <br />1 <br />SPECIAL CONDITIONS: <br />OTHER <br />1 <br />I <br />PENELTY <br />SEC. 3OJ W <br />I <br />TOTAL <br />TIoO <br />PERMIT VALIDATION <br />WHEN PROPERLY VAIJOAT ED IIN THIS SPACE) THIS IS YOUR PERMIT <br />PMLICATION ACCFPTEDBY <br />LANSHECKED BY <br />MOVEDuIARE Y <br />� <br />0 <br />