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[heEucrgreen �� �ONSTRUCTION --� ^ <br />CITY OF <br />everett PERMIT PERMITNO. _ ���5� <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWHER MAILADDRE55 GITY ZIP PHONE <br />Pinehurst Baptist Church Inc. 1902 Madison Everett 982G3 353-7620 <br />TENPNT MRILAD�RE55 CIT� :IP PHONE <br />Same <br />ARCHITECTONDESIGNEH MAILAODRESS CITY ZIP PNONE <br />Doug Engelson 339-1175 <br />GENEHALWNTRACTOR MAILAO�fiE55 CITY ZIP PHONE 4CENSEu <br />Jerry Baintan 32507 Abriams 1�ve. Black Diamond 886-2587 BAINTBC209BV <br />MECNANICALCONT{1RCTOq HAILADpRE55 LITY ZIP PHONE LICENSE� <br />FLUMBING <br />GLA55 OF WORK <br />❑ NEW <br />GIiY 21P PMONE LICENSE+ <br />� ADDITION ❑ ALTERATION ❑ REPAIR O DEMOLITtON ❑ BUILDING HELOCATION <br />I CONTAQ PERSON AND PMONE NO. IF pIHEfl TM \N NdOVE <br />CONTRACT PRICE OF WORK: $ 3G � 000. 00 <br />' �ESCRIpE WOPN AND SOUARE FOOTAGE INVOLVED <br />xeplace foundation excavate and add space <br />I <br />PROPOSEO USE OF BUILOtNG <br />; Sunday School Space <br />LEGAL OESCRIPTION OF PROPERTY �SHOW BELOW OR ATfACM FOUR W PIES� <br />LOT _— BLOCK _ OP <br />190"< Madison St. <br />PLU�ABING <br />NO. TYPE OF FI%TURE OR ITEM <br />'�VATER CLOSET (TOILET) <br />BATIiTUO <br />LAVATORV�WAuHBASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />'lI5HWA5HEN <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAI <br />OflINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF ORAINS — RAINLEADERS <br />SINK ISERVICE — BAF, ETC.1 <br />FqONTSETBRCK <br />exist _ <br />USEZONE <br />R-2 <br />tYi4 Of CANSLPIICiION AlLOYIAb <br />V-N <br />512E OP OL�G <br />748 add <br />OCCl1PaNCV LOAO <br />63 a <br />REASONiORSPFINNL[RS <br />APPIICATION ACC �Y <br />M.M. <br />SUBTOTAL <br />PEqMIT <br />TOTALFEE <br />exist <br />AREA <br />fYPE OF WI�SiAUCiION ACTOAL <br />V-N <br />NO. OF STORIES <br />1 <br />FIRE SPRINKlEFS PEO'D <br />7 YES j�NO <br />� <br />S <br />S <br />SIDE SETBACN <br />exist <br />VACANT SITE <br />]YES C3FN0 <br />a'�Wo�"�'« NOOFONELLING <br />A-3 0 <br />phSEM1IENT <br />�j VES ❑ NO <br />HEIGIIT LIM�TATION <br />exist. <br />'"„"""'°" I CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />B•E• 3105 <br />MECHANICAL <br />NO. TYPE OF EOUIPAIENT <br />A/C - NHNDLG UNITS - F�.P. <br />FORCED AIR SVSTEMS - B.T.U. M EA. <br />UNITHEATERS—B.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATEF <br />WOODSTOVE <br />METAL FIREPLACE 8 <br />FIREPLACEINSERT <br />HEAT FUMP <br />GAS PIPING <br />E%HAUSTFAN <br />1N CHECK NUMBER <br />99,�23480 <br />SUBTOTAL <br />PEHMIT <br />TOTFLFEE <br />FEE <br />210.28 <br />BUILDING 5 <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />FE E <br />� <br />5 <br />S <br />RECEIPT NO. <br />29964 <br />IS YOUR PERMIT <br />PERMITS EXPIRE IF `NORK IS NOT COMMENCED WIThIN ) "j t� �i <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. ��UREBS FILE �.)�- l 1�_ <br />