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1 <br />`��""�'�" _�.,�� ;:�.;ONSTRIl�CTION �`' ��:����� <br />CITYOF '�'�'j7 j,,.�.i <br />everett PERMIT PERM�T No. 23117 <br />259-8810 <br />�(H DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBIN6 O SIGN <br />OWNER M�IL�O�RE55 CITY 21P PNONE <br />R. Euteneier 1504 E. Lakeshore Dr. Lake Stevesn 98258 334-8383 <br />TEN�M MAIL ADORE55 CITY ZIP PHONE <br />ARCMITECTORDi710NER MAILA�ONE53 CITY ZIP PF:ONE <br />OENEflALCOM��CTOR MAILADUf1ES5 CIiY 21P PMONE LICENSE� <br />Owner <br />MECHANIC�ICONT�dCT00 M�ILADDIIESS pTY 21P PHOVE LICENSE� <br />1'LUMOINOCONIMCI00 MAll�bltllf69 GTY ZIP PI�ONE IICEN5E1 <br />CUSS OF WORN ` <br />❑ NEW ❑ A�DI11nH O ALTE'IATION ❑ IIEPAIR �EMOLITION ❑ BUILDINO RELOCATION <br />�ND 1110NE N0. If <br />CONTRACT PFICE OF WORK: S <br />OE•uCRIBE WORN �NU SOUANC FOOTAOE INYOLVED <br />Demolish House npp. 4�nef <br />PROPOSED USE OF BUILDINO <br />Single family reaidence _ <br />LEWL OESCflIPTION OF PROPERTY (SI IOW OEIOW OR �iT�CM FOUR CAPIES� <br />The S.� of lot 5 and the S�i of the N.� of lot 5 Beverly Azcrcaae Tracta <br />lOi � BLOCN � OF <br />PLUMBINa <br />WATER CI <br />BATMNB <br />SINK 6 DISP. <br />MECHANICAL <br />OR ITEM FEE NO. TYPE UF Ef <br />NC — NHNOLO UNIT9 — <br />FORCED AIR SYSTEMS— <br />UNIT HEATERS— B.T.U. <br />CLOTHESOHYERS <br />VENTILATIOP fAN <br />CLOTI.ES WASHEP <br />URINAL <br />DHINKINQ FOUNTAiN <br />FI.00R UMIN <br />F�ACKFLOW PREVENTERS <br />ROPF OMINS — MINLEADERS <br />6111N �SERVICE— BRR, ETC.� <br />6UBTO7AL <br />PEHMIT <br />TOTALFEE <br />FRONTS'eTB11LN OFJ�RSETBFCK <br />U9E 20NE � �OT MEA <br />ryl(OLCWSfNUCIpN�LLONABIE IYIEOFfAN,51PWfl <br />A <br />�' SREOFBLDO. <br />, OCCUPANCYlO�.J <br />PEASON FOR ��Pf11NYLEf15 <br />I <br />AVPLICATION �CG BY <br />� <br />' S.H. <br />IE SPf11NNlEB3 REO'0 <br />YES O NO <br />910ESE7B�CK <br />V�CAYT 91TE <br />❑ YES ❑ NO <br />�'� NOOFONFIUrp�1N <br />OASEM'Ni -- <br />❑ YES O NO <br />HEIONT LIMITATION <br />CITY GF EVERETT <br />LOCAL SAI_ES <br />TP.X CODEi IS <br />PERMIT5 EXPIRE IF WOAK IS NOT COMMENCED WITHIN <br />160 DAYS OR C�ASES FOR NiORE THAN 1R0 DAYS. <br />�— •� <br />METAL FIREPUCE <br />FIREPUCE INSEHT <br />HEATPUMP <br />6AS PIPINO <br />fKMALSTFAN <br />PLAN <br />BUBTOTAL <br />PEHMIT <br />TOTAL FEE <br />FEE <br />BUILDINO S <br />PLUMBINO <br />MECHANICAL <br />OTHER <br />STATE BUILDINO SURCHANOE <br />STATE ENEfiOY SURCHAROE <br />PII�LIC WORKS <br />TOTAL <br />ADDRESS FILE <br />M EA. <br />RECEIPT NO. <br />23117 <br />4 <br />