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� r � <br />ay <br />�C.�H <br />9Hcn <br />y�H <br />K n <br />O x0 <br />"i1 H'�J <br />V7 H <br />y t'' <br />z <br />�ya <br />��� <br />7� � <br />zH� <br />�yz <br />C H '� <br />Oy <br />H <br />(] C V� <br />�r�r <br />C�] C�7 <br />2 H p� <br />HON <br />CITY OF EVERETT <br />�ONSTR�JCTION � � <br />r PERl�ilT PERMITNO. 2%E71 <br />zse-ssyo <br />❑ DEMOLITION }Q� COM8INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUM6ING ❑ SIGN <br />O'NtlER <br />lAARhDORE55 CITY ZIP FHONE <br />Charles Lacke 6504 Lombard Everett 98201 pHonE <br />TENRNT <br />iananoor+er cin zia <br />FRGHRECTORDESWNER <br />MAILADORE55 QTY ZiP PNOt�C <br />MAILAOORE55 � GITY ZIP PHONE LICENSEY <br />GENcqALGONiRAQOR ' _ _ �„��„ .�., nv� � +nvr.xcl OtiKti <br />"•"�n`S ' - ---- - - PnONE LICENSE• <br />MAILFOURE55 ���Y Z�P <br />PLUMBING CONTRACiOR <br />MAILAD�RESS CITV Z�P iHONE LICENSEN <br />ClAS50F WORK <br />❑ NEYJ MH ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILOING RELOCATI <br />cI�MALT PERSON ANO PH@1E NO. IF OTHER THAlJ A�OVE <br />CONTRACTPRICEOFWORK:$ tfanK nrown v��-�..�� <br />�[SCRI�E WORK ANO SOURRE FOOTRGE INVOLVED <br />Bathroom & bedroom addn; 364 SF <br />!7:�2�"i 700RN03°l kki <br />PROPOSED USE OF dUR�ING <br />LEGRL D`.SCPiPTION OF PROPEHTY �SHOW OELOW OA /TTA-�1 FUJR COPIES) �SI�OOG rE� (S <br />e� o� sieo-ao <br />LOT�OIOCK�OF P� BG 81�.00 <br />N� 1,2,3,4 Block O10-D-Ol of Pinehurst F: gFCH Q<<•�'7 <br />C�ErI; xi.99,�0 <br />�oonooaess <br />6504 Lombard Ave <br />PLUMBING <br />LAVATORV (WASH BFSIN� <br />SHOWEq <br />KITCHEN SINK 8 OISP <br />OISNWASHER <br />LAUNDflYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRIN�CING FOUNTAIN <br />FLOOR �RAIN <br />BAGKFLOW PflEVENTERS <br />ROOF DRAINS - RAINLEADERS <br />SINK (SERVIGE - BAR, ETC.) <br />SUBTOTAL 5 <br />PEflMR 5 <br />TOTALFEE 5 <br />=R011TSEi�nCY. P[ARSET�PCN SIOESE <br />� z � 5 <br />USEZONE IOTPREF VAC/NT <br />❑ YES <br />iYPE0FC0�bTRUCiIONALLO'.YAEIE T.PEOFLONSTRUQIO4ACtuA ���;"Y <br />V-N R-3 <br />SRE OF �LOG. Il0 OF SLORIES OASEMI <br />fSqY <br />ACC �+ <br />LSPRR1NlER5REOD HEiGMTLV <br />Y[S E�:vO 28� <br />IqPPFOV[OOV I CITY OF EVERETT <br />� LOCALSALES <br />TAX CODE IS <br />3105 <br />PERMITS EXPIRE IF WORK IS NOT COMMENC�^ u'!T.`IIN <br />180 DAYS OR CEASES FQR MORE THAN 180 �AYS. <br />MECHANICAL <br />JO. TYPE OF EOUIPIAENT <br />A/C - NHNDLG UNITS - H.P. <br />FORCE�AIFSYSTEMS-BTU. MEA. <br />11NITHEATEFS-B.T.U. �+� <br />CLOTHESDRYERS <br />VENTILAiIUtJ FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD 3TOVE <br />MEIAL FIREPLACE 8 CHIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL 3 <br />PEFMIT 5 <br />'LANCHECKNUlABER FEE ne�or��.... <br />27671 117.00 53418 <br />FEES ° vn�uqiloR�E F� <br />BUILDING S 1 38 <br />PLUMBING <br />IdECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGVSURCHAHGE <br />PUBLIC WORKS <br />TOTAL � I lJyl <br />WHEN PROPERLY VALIDATED THIS IS YOUR PrRMIT <br />!Vi'-i.'�, _ -� _ <br />'� ;' (-� j � <br />• <br />