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"��'��� �� C'`NSTRUCI'ION �� � <br />everett PERMIT PERMITNO. 22�69 <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING %] MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILAODRESS CITY ZIP PHONE <br />Larry Siep 5610 Fleming St. Everett, WA 98203 347-3656 <br />TENANT MAILA�DflE55 CITY ZIP PMONE <br />AHCHITECTOFDESIGNER MAILADDflESS CITY ZIP PHONE <br />GENERALCONTRACTOR MnILA00RESS QTY ZIP PMONE LICENSEw <br />� MECHANICALGONTflFCTOP MRILNDORESS CITY ZIP PHONE LICENSE♦ <br />Valley Natural Gas 2605 MCDougall Everett, WA 98201 259-5492 VALLENG153LI <br />PLUMBINGCONTRACTOR MAIL/ODRESS CITY 21P PNONE LICENSE• <br />CU55Of WORK <br />❑ NEW O ADDITION $1 ALTERATON ❑ HEPA�R ❑ DEMOLITION ❑ BUILDING RELOCATION <br />I GONTACTPERSONANDPMONENO.IFOTHERTHANABOVE <br />CONTRACT PRICE OF WORK: $ <br />Install�boilercand�water�heater <br />P110POSED USE OF BUILDING <br />SSf[iji[2XlN0123t1[ Single family residence <br />LEGAL DESCHIPTION OF PROPEflTY �SNOW BELOW OR ATTAGH FOUR COPIES) <br />LOT- BLOCK- OF <br />JOB ADIXiE55 <br />5610 Fleming St. <br />PLUMBING <br />USE20NE <br />FIXTURE ON ITEM <br />BATHTUB <br />UVATORV (WASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DMIN <br />ROOF DMINS— RAINI <br />SINK 1SERVICE — BAR. <br />SUB TOTAL <br />PERMIT <br />AREA <br />iYPEOFCON57PUCTIONALLOWABtE �ttPECFtON5ip11CTI0NACNAL <br />SREOFBLDG. <br />OCCUPANCYLOAD <br />REASON FOR SPRINNLERS <br />APPLICATION ACC. BY <br />M.M. <br />N0. OF STORIES <br />FIFE SPRINKLERS REO'D <br />❑ VES ❑ NO <br />PLANSAPPROVE06Y <br />FEE <br />CANT SITE <br />VES ❑ NO <br />YES ❑ NO <br />MEIGMT LIMITATION <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />3105 <br />MECHANICAL <br />A/C — A/HNDLG UNiTS — H.P. <br />FOFCED AIR SVSTEMS — B.T.U. M EA. <br />UNITHEATERS—B.T.U. M <br />CLO7HESORVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPL4CEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />CHECK NUMBER <br />SUBTOTAL <br />PERMR <br />T07ALFEE <br />FEE <br />FEES <br />BUILDING $ <br />PLUMBING <br />MECHANICAL 5� <br />OTHER �I <br />STATE BUILDING SUFCHARGE �' <br />STATEENERGVSURCHARGE <br />PUBLIC WORKS <br />WHEN PROPERLY VALIDATED <br />f <br />iP2 <br />�� <br />30 <br />PERMITS EXPIRE IF WORK IS NOT COMMEN�ED WITHIN ADDRESS FILE 2 G 2 Ll �j <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />