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the Evergreen <br />CITY OF <br />everett <br />OFF NAIL )9$615 <br />FVf Pf N. w"HINGtON <br />RNI <br />OEPI OICPT <br />u(1PVf <br />otvmu[Nt BUILDING <br />CONSTRUCTION <br />PERMIT <br />MECHANICAL <br />everett <br />PLUMBING Ille� <br />OWNER N•�FLN ��♦ MAIL ADDRESS /N• PHONE <br />P1xv 1A"' J4� <br />ARCHITECT OR DESIGNER MAIL ADDRESS FHONE LI E WST N0. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />�s NE <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />PLUMBING CONTRACTOR MAIL ADDRESS Piro nit LICENSE NO. <br />PERMIT CLASSOF WORK <br />JOBUILDING []PLUMBING ❑ MECHANICAL <br />❑NEW SADDITION ❑ALTERATION ❑REPAIR <br />3W-77 <br />Ui <br />W <br />D] <br />Z <br />~ <br />VALUATION OF WORK <br />f f_yM M <br />4w%00 <br />❑DEMOLISH ❑FENCE []SIGN❑SWIMMING POOL <br />0: <br />W <br />a <br />OESCRIBF WORK �N� ��FFBIP�� � r <br />�'F'N �enil di!'AGii!!!1 �`� <br />(� ((�P <br />2112 <br />PROPOSED USE <br />MECHANICAL <br />TYPE OF FUEL ❑OIL UAAS. LPG. ELEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW RFOW OR ATTACH <br />L <br />FOUR C.QPIESI <br />LOT! BLOCK —OF r'' <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />f 1 <br />REFRIGERATION UNITS HP EA <br />BOILERS H.P. EA. <br />I <br />GAS FIRED A.C. UNITS -TONNAGE EA. <br />FORCED AIR SYSTEMS-8.T.U. M EA. <br />I <br />JOB ADDRESS Pµy <br />WALL HEATERS -B.T U. M <br />UNIT HEATERS-A.T.U. M <br />I <br />EVAPORATIVE COOLERS <br />PLUMBING <br />CLOTHES DRYERS <br />I <br />VENTILATION FAN <br />RANGE HOOD <br />I <br />AIR HANDLING UNIT- C.F.M. <br />TYPE OF FIXTURE OR ITE <br />FEE <br />INCINERATOR <br />1 <br />WATER CLOSET(TOILETI <br />f <br />[NO. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK d DISP. <br />SUBTOTAL f <br />I <br />DISHWASHER <br />LAUNDRYTRAY <br />PERMIT f <br />TOTAL FEE 6 <br />I <br />CLOTHES WASHER <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 />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEDTHIS A <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRORR CORRECT. ALLL <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 />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PCfiFORMANCE OF CONSTRUCTION. <br />x <br />WATER HEATER <br />_ <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR -SINK OR DRAIN <br />- <br />VACUUM <br />AIN -RAINLE LEADERS <br />ROOF DRAINS- RAIN <br />SINK (SERVICE -BAR ETC.) <br />SUB TOTAL <br />PERMIT— <br />TOTALFEE <br />f <br />__ <br />SIGNATURE OF CONTRACTOR OR AUTH. AGENT DATE <br />SIDE YARD SETTSTREEI <br />REAR YARDSETBAC <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />�RECEIPT_ <br />FEEFEE NO, <br />USE ZOFj•� �64 <br />VACA NTTSITEj7�❑YES 41NO <br />FEES <br />•I DING <br />-•,181NG <br />''I CIIANICAL <br />VALUATION <br />FEE <br />TYPEOF CONSTP <br />UNITS OWE L�IN6ISIZEZEOG. <br />S• <br />__ <br />MnX. OCC. IOAD <br />i— <br />FI NE <br />DA^uCM 'T <br />FI S I L <br />RCUUIRED <br />❑YES ItNO <br />I <br />SPEr'IAl CONDIi•ONu. <br />OTHER <br />I <br />PENELTY <br />SEC, 3031P) <br />I <br />-- <br />TOTAL <br />1 <br />�lam <br />-- ------------- <br />PERMIT VALIDATION <br />WHENPROPLRIVVAIIDATEOIINIi415SPACFIT111SISYEIURPERMIT <br />TIII:A110N A[CfP1FD PY 1'I ANYJIIFf.Kf.D PY <br />11PPPOVFO fO /ISSOANFf P� <br />ti <br />ja <br />