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�E°�"�' � Cf^�NSTRUCTIONi � '"'� <br />CITY OF <br />everett PERMIT PERMITNO. 221 9� <br />259-8810 <br />❑ DEMOLITION O COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />CWNER MAIIADpFE55 CiTV ZIP PHONE <br />Mike Wilson 5428 Lowell Rd. Everett 98203 355-0818 <br />TENFNT AIAILAODRE55 CITY ZIP PHONE <br />Same <br />ARCHRECT Oq OESIGNER MAIL AD�9E55 CITY 21P PHONE <br />GENENALCONTPACTOP M41LApORESS CITV ZiP PHONE LICENSE� <br />Same <br />MECMANICALCONTRACTOR MAILApORESS �ITY 21P PIIONE 4CENSEx <br />PLUMBINGCONTP/CTOP MAILADDRESS CITV ZIP PMONE LICENSE+ <br />CU55 OF WORK <br />❑ NEW ❑ ADDITION P5 ALTEHATION <br />CONTRACT PRICE OF WC AK: $ 8 700. 00 <br />❑ :-� -�AIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />CONTACT VERSON AND PHONE NO. IF OTMER THAN ABOVE <br />�I� iVVPXL�VVIRlatI1VVV�V[I] <br />Replace 24' section of foundation wall <br />PNOPOSED USE UF Bl11LDING <br />SFR <br />LEGAL DLSCRIPTION OF PqppERTY (SHOW BLIOW OR ATTACM FOUR COPIES� <br />LOT — BLOCK _— OF <br />J09ADDPESS <br />5428 Lowell Rd. <br />PLUMBING <br />NO. I TYPE OF FI%TUHE OR ITEM <br />—~ WATER CLOSEf (TOILET) <br />BATHTUB <br />LAVATORV (WASH BASIN) <br />SHOWER <br />KITCHEN SIMK 8 DISP. <br />DISHWASHER <br />LAUNDRVTRAV <br />FLOOR DRAIN <br />BACNFLOW PREVENTERS <br />FOOF DRAINS- flAINLEAOERS <br />SINK �SERVICE - BAR, ETC.) <br />SUBTOTAL f <br />PEflMIT f <br />FRONT SETB�CK <br />` USE�ONE <br />iYfE OF L�NSiflOClION AILOWaBLE <br />SIZE OF OLDG <br />OCCIIPANCYLOAO <br />S.H. <br />�OT AqEA <br />fVPE OF CdNSiNUL�lOI <br />NO.OF STORIES <br />FlFESPFINNLERSi <br />7 VE:i ❑ NO <br />WS APPROVED 0 <br />J.W. <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A/C — NHNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />11NI7HEATERS—B.T.U. M <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WAiER HEATER <br />WOODS70VE <br />METAL PIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />PEAMIT <br />TOTALFEE <br />SETBacK � PLAN CHECK NUMBER <br />� <br />❑ YES ❑ NO <br />FEES ��'�^"n^°�ci <br />ACiG4l �'��r� NOOFOWELLINGUN175 BUILDING �Q�q`�� <br />.,�„• <br />PLUTABING e SRCH <br />BASEAIENT � <br />O YES ❑ NO MECHANICAL <br />EO'D MEIGHT�IMITqTION OTHER <br />Pl.an Ck <br />STATE BUILUING SURCHARGE <br />STATEENERGYSURCHARGE <br />CITY OF EVERETT <br />LOCAL SALES PUBLIC WORKS <br />TAX CODE IS TOTAL <br />3105 <br />S <br />S <br />FEE <br />19 <br />�� <br />PROPERLY VALIDATED TFIIS IS YOUR PERMiT <br />PERMITS EXPIRE IF WORK IS NOT COMMEW(:ED WITHIN '�'" <br />ADDRESS FILE �, �' � � <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />L <br />