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CITY OF EVERE7T � <br />� I�ONSTRUCTION � '� <br />" PERMIT PERMITNO. 2%�71 <br />259-88f0 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SI�N <br />OWNER MAILADDRESS LITV 21P PHONE <br />4201 Roosevelt Way NE Seattle 98105 547-1222 <br />��� MAILADDRESS CITY ZIP PMOr1E <br />ARCMITECTORDESIGNER MAILAUDRESS CITY ZIP PHONE <br />6ENEPALCONTFACTOR MAILADDPE55 CITY ZIP PHONE IICENSE� <br />MEGIANICQCONTFACTOR MAILAOORESS CITV ZIP PHONE UCENSEI <br />PLUMBINOCONTRACTOH MAILADDRESS CITV ZIP PHONE LICENSE• <br />itav's Plbq & Htg PO Box 2272 Redmond 98053 868-2032 RAYSPH*1580T <br />❑ NEyy ❑ pDDRION <br />CONTRACT PRICE OF WORK: <br />Plumbing <br />❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDINfi RELOCATION <br />CONTACT PERSON AND PHONE NO. IF OTHER THAN ABOVE <br />PROPOSED �'SE OF BUILDING <br />LEWL DESCRIPTION OF PROPERTV (�MOW BELOW OH A17ACH FOUR COPIES) <br />LOT�_ BLOCK _ <br />10/03J41 11�3?Ati OOOAN0366 �Kf <br />/ <br />��,E� #00027871 <br />9121 Evergreen Way P F6 �150.� — <br />PLUMBING <br />NO. � <br />BATHTUB <br />FLOOR DRAIN <br />BAi.KFLOW PREVENTERS <br />ROOF DRAINS - RAINLEADERS <br />SINK (SERVICE - BAR, ETC.) <br />SUB TOTAL S <br />PEHMR S <br />iOTALFEE 5 <br />FROMSETBACN REAR SEf&1CN SIDE SRBACK <br />USEZONE LOTAREA VACANTSITE <br />O YES ❑ NO <br />TYPEOFWNSiPUCTIONALLOMABLE TYPEOFCONSTRUCTIONACTUAI �'qa�r �;p.pFpN[WNGUN <br />S2EOFBLDG. NO.OFSTORIES BASEMENT <br />❑ VES ❑ NO <br />OCCUPANCVLOAP FIRESPRINKLERSREO'D MEIGMTLIMITATION <br />❑ VES ❑ NO <br />REASON FOR SPflINKLERS <br />qPPLICATIONACC.BY PLANSAPPROVEOBY CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />3105 <br />MECHANICAL �nu.n <br />NO. TYPE OF EQUIPMEN7 <br />A/C -AMNDLG UNITS - H.P. <br />FORCEDAIRSVSTEMS-B.T.U. M <br />UNITH'tATERS-B.T.U. ti1 <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOJD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACE INSERT <br />HEATPUMP <br />SUB TO <br />PEPMR <br />TOTALI <br />NUMeER � FEE <br />FEES eu�� <br />BUILDING <br />PLUMBIN � <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />S7ATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />PROPERLY <br />$ <br />YOUR <br />, <br />C <br />9 <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN 2 7 H 71 <br />180 DAYS OR CEASES FOR �NORE THAN 180 DAYS. ADC11'ESS FILE _ <br />