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CITY OF EVEREIT �� <br /> Y` �ONSTRUCTION � � � ` <br /> - PERMIT PERMITNO. 27610 <br /> 259-8810 <br /> ❑DEMOUTION ❑COMBINATION ❑ BUILDIN� ❑MECHANICAL ❑ PLUMBING ❑SIGN � <br /> JWNEH MRILAO�RESS CITY ZIP PMONE <br /> Glen Ericson 4718 Black Forest Lane Ererett 98203 259-1002 <br /> TENqNT MNILADORESS CITY bG PHONE <br /> � � �' �qCHRECTOfi0E51GNER MAILFOURESS CITV ZIP PHONE ��� { <br /> ���� OENERAILONTRACTOF MAILAO�FESS CITV � ZIP PHONE LICENSEN � � <br /> � <br /> � � MECWINICF�CONTRACTON MAILADORE55 CITY ZIP PMONE LIGENSEN I <br /> �r�]i Thomas Heating 14522 NE 190th Woodinville 98072 486-6883 THOMAH*140BM <br /> �M� PLUMBMGCONTRFCTOR MAILADORESS CITY ZIP PXONE LICENSEX •: <br /> ��p� Ff <br /> � C1A530F WORN �M�t � <br /> HC <br /> ❑ NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION � �� <br /> ��� CONTACT PEPSON AND PHONE NO.IF OTHER TNRN ABW E y�h. <br /> [tl CONTRACT PRICE OF WORK: $ 700 r t �n '� <br /> H� � OESGRIBEWORKAN�SOUARFFOOTRGE�NVOLVED . �^� �?"` �. <br /> Z�y� Hot �iciva water heater and gas piping � ���,�,���. <br /> L"' <br /> ►a y <br /> �!��y <br /> � PROPOSEDUSEOFBUIL�ING <br /> �a SFR <br /> �;�� LEGrAOESCFIPTIONOFPROVERTV(SHOWBELOWORATfFCHFOURCOPtES) <br /> �y� 02/28,r4:� 1C:ObAM OOOf;t966:i� �K:KYk <br /> yp�p LOT_BLOCK_Of � <br /> #00027{,10 <br /> MEbH #fi5 2B <br /> CHEGi; 845,�70 <br /> J08RDORESS <br /> 4718 Black Forest Lane <br /> �. PLUMBING MECHANICAL . <br /> � NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOII.ET) A/C-A/HNDLG UNITS-H.P <br /> BATHTUB FORCEDAIRSVSTEMS-B.TU. MEA. <br /> LAVATORV(WASHBASIN) � UNITHEATEFlS-B.T.U. M <br /> SHOWER CLOTHESORYERS . <br /> KITCHEN SINK 8 DISP. VENTILATION FAN <br /> �� OISHWASNER RANGEHOOD <br /> � � IAUNDRV TRAY WATER MEATER <br /> 1 � CIOTHESWASHEP WOODSTOVE <br /> � <br /> � URINAL METAL FIREPLACE 8 CHIMNEV <br /> � DRINKING FOUNTAIN FIFEPLACE INSERT <br /> ( FLOOR ORAIN HEAT PUMP <br /> BACKFLOWPREVENTERS 1 GASPIPING <br /> '� ROOP DRAINS-RAINLEADERS E%HAUST FAN <br /> � � SWK�SERVICE-BAR.ETG) <br /> � <br /> ' SUBTOTAL S SUBTOTAL S 30 00 <br /> ; �� PEPMIT $ PERMIT 5 ].S OO <br /> TOTAL FEE $ TOTAL FEE $ 45 00 <br /> ' FRONiSETBaCN REARSETBACH SI�ESETBaCK PLANCHECKNUMBER FEE RECEIPTNO. <br /> USEZONE LOTAREF VHCANTSITE <br /> � FEES BUILDINGCOOE FEE <br /> ��. . ❑VES ❑NO VAWPTON _ <br /> � I ttPEOffqNSiPIIQ:ONAILOWA6LE TVPEOFWNSTRUCTIONACTOAL a�qoup�� NOAFpWE1.ONGUWiS BUILDING $ <br /> PWMBIIJG <br /> G� SIZE OF BlD6 NO OF STORIES BASEM[NT -- <br /> ❑YES ❑NO MEGHA�IICAL ¢S OO <br /> OCCUPNNCYLOPO FIFESPRINNLEP53EbC HEIGHTLiM'TqTIUN <br /> OTHEP <br /> ❑YE$ ❑NO <br /> RFASON FOR SVRINKLERS STATE BUILDING SURCHAflGE <br /> STATEENEFGYSURCHARGE <br /> APPULATIONACC.BV P�ANSAPPROVEDBV CITYOFEVERETT <br /> LOCF+L SALES PUBIIC WORKS <br /> TAX CODE IS TOTAL 45 00 <br /> 3105 <br /> WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT <br /> PERMITS EXPIRE IF WORK IS NOT COMMENCED W�THIN 2 7 610 <br /> 180 DAYS OR CEASES FOR MORE THAN 180 DAYS. Ai'�I';?.eg-qc cpr F <br />