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CITIf OF EVERETT <br /> � �'ONSTRUCTION � '�� <br /> PERMIT PERMITNO. 273 ? Q <br /> 259-88f0 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING $� MECHANICAL ❑ PLUMBING G SIGN <br /> OWNER MAILADDRESS CITV 21P PMONE _— <br /> Norm hliddlesletter 2117 Lombard Ave Everet;: 98201 337-5655 <br /> TENANT MAILADDPE55 CITY ZIP PHONE <br /> ARCMITECTOF�ESIGNER MAILAD�RESS CIiY 21P PHONE <br /> GENERFLCONTPACTOR MAILA.�ORF55 CITV ZIP PHONE LICENSEn <br /> MECHANICA�CONTFACTOfi h1FILA��RE55 „ITV ZIP PMONE LICENSE� <br /> Northwest [daterheater Inc 3110 Hill Ave �verett 98201 259-5331 NORTHWH103R2 <br /> PLUA'BINGCONTRACTOR MAILADDRE55 CIN ZIP PHONE LICENSE+ <br /> CIAS$OF WORK <br /> %] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> CONTACT PERSON AND PNONE NO.IF OTHER TMAN ABOVE <br /> CONTRACT PRICE OF WORK: $ 1300 <br /> DESCRIBE YlORK AND SOUARE FOOTAGE INVOLVED <br /> Install gas furnace and waterheater <br /> PROPOSED USE OF BUIL�IN6 <br /> Single FAmily res <br /> _ m��^iay a:iSars nnnA�ve�� rc�::; <br /> LEGAL DESCRIPTION OF PROPEFTV ISHOW BELOW OR ATfACM FOUR COFIES) / <br /> LOT_BLOCK_OF NI100^7i74 <br /> MECH 9�5.00 <br /> rNFrF� ass oa <br /> JOBADDRESS <br /> 1117 Lombard <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A/C-NHNDLG UNITS-H.P <br /> BATHTUB FORCE�AIRSYSTEMS-B.7.U. fdEA. <br /> LAVATORY�WASHBASIN) 1 UNITHEATERS-B.TU. fd <br /> SHOWER CLOTHESDRVERS <br /> KITCHEN SINK 8 DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDI7YTflFY � NJATERHEATER <br /> CLOTHES WAiHER WOODSTOVE <br /> URINAL METAL FIREPLACE S CHIMNEY <br /> DRINKING FOINTAIN FIREPLACE INSERT <br /> FLOOR�RAIP HEAT PUMP <br /> BACKFLOW P.7EVEIJ7ERS g GAS PIPIM1G <br /> ROOF DRAIN: - fiAINLcADERS EXHAUST FAN <br /> SINK(SEPVICi:-B4P,ETCJ <br /> SUB TOTAL 5 SUB T'JTAL 5 <br /> PEHMIT 5 pERM1T 5 <br /> TOTALFEE S TOTALFEE 5 <br /> FRONTSETpACK R=_AqSETBnCK SIDESETOACK PLANCHECKNUMDC-R FeE RECFIPTNO. <br /> USE20NE LGTAREA VACANTSRE <br /> FEES BUILOINGCOOE FEE <br /> ❑YES ❑NO �A�UATION _ <br /> iIPLOfLONSTRUCiIONALLOYNEIE TYPEOFCONS1ROCilONACiUAL a���!pv NOAfOHElCC1GUNIiS BUILUING �S <br /> PLU1.181NG <br /> SIZE OF BLOG NO.OF STORIE$ OA:EMENT <br /> ❑vC5 ❑NO MEGHANICAL <br /> GCCUPAMCVLOFD FIRESPRINKLERSRCO'� HEIGNTLIM!TAT;OtJ OTHER <br /> ❑YES ❑NO <br /> PEASON FOH SPRIr:r,t,EaS STATE BUILDING SURCHARGE <br /> STATE ENERGV SURCHARGE <br /> APPLICATIONACC.BY 'LAN5IPPROVED�V CITY OF EVERETT <br /> LOCAL SALES PU�LIC WORKS <br /> TAX CODE IS TOTAL 55 00 <br /> 3105 <br /> WHEN PROPER�� VALIDATED THIS !S YOUR PEF�MIT <br /> .�� <br /> PERMITS EXPIRE IF WORK IS NOT COMMENCED WITNIN 2 l 3 7 4 <br /> 180 DAYS OR CEASES FOR MORE THAN 180 DAYS. G��'n�>''•;'` �'��`- <br />