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ay <br />tDxx <br />r H <br />9 yxyx Vr <br />H Z� <br />Ox0 <br />?1 H 14 <br />[A H <br />y grg <br />mom <br />m <br />yC <br />OH <br />HMO <br />00 <br />9 H3 1 <br />r z <br />0 �H <br />0 L7 N <br />theEvergreen <br />_w <br />-- <br />ciryOF <br />QfY <br />C-INSTRUCTION <br />�7 <br />2652 <br />everett <br />PERMIT <br />PERMIT NO. f <br />259-8810 <br />❑ DEMOLITION <br />❑ COMBINATION ❑ BUILDING <br />❑ MECHANICAL <br />C PLUMBING <br />❑ SIGN <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Cindy Finden <br />2109 Hot Everett WA 98201 <br />259-0710 <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />TENANT <br />` ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />MECHANICAL CONTRACTOR <br />MAILADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />PLUMBING CONTRACTOR <br />MIILr (DRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE• <br />Owner <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION M REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO IF mnm mnry newt <br />CONTRACT PRICE OF WORKS 3 DD0 <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />Bathroom <br />PROPOSED USE Of BUILDING <br />Rec room & Storage Sfr <br />LEGAL DESCRIPTION. OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPES) <br />LOT — BLOCK — OF <br />21U!% Ho t <br />PLUMBING <br />MECHANICAL <br />NO.WWATERCLOSET <br />OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />A✓C-A/HNDLG UNITS-H. P. <br />1 <br />ITOI LET) <br />FORCED AIR SYSTEMS - 8.T.U. M EASH <br />UNITHEATERS-BTU. 02/2VIIN2'-18P1DODiIgS7 <br />�6 <br />BASIN) <br />QD_ <br />DRYERSd <br />_CLOTHES <br />VENTILATION FAN 000026527 <br />DISR <br />PLES $30. <br />RANGEHOOD <br />WATER HEATER CHECI( $30. <br />LAUNDRY TRAY <br />WOOD STOVE <br />CLOTHES WASHER <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS - RAINLEAD ERS <br />E%HAUSI FAN <br />1 <br />SINK ISIERVICE -- BAR. ETC.( <br />S <br />00 <br />_ <br />SUBTOTAL S <br />20 <br />lQ <br />SUBTOTAL f <br />PERMIT <br />f 10 <br />DO <br />PERMIT <br />f <br />TOTAL FEE <br />S ;o <br />I QO <br />TOTALFEE <br />f <br />FRONT SETBACK <br />RERSE'IBACK SICESETUACII <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOTAREA VACANf <br />SITE <br />FEES <br />SWILL DCODE A ION <br />VRLI <br />FEE <br />❑ YES ❑ NO <br />BUILDING <br />g <br />5K— CONSTRUETIONAUMADU <br />PRE BF CBNStRLOTDN ACTUAL <br />"mj°D�vA'NB <br />OF BWEIIIAG UNIt$ <br />PLUMBING <br />SIZE OF BLDG <br />NO. OF STORIES <br />BASEMENT <br />YES ❑ NO <br />MECHANICAL <br />OCCUPANCY LOAD FIRE SPRINKLERS REOD HEIGHT LIMITATION <br />OTHER <br />❑ YES ❑ NO <br />STATE BUILDING SURCHARGE <br />REASON FOR SPRINKLERS <br />STATE ENERGY SURCHARGE <br />_ <br />APPLICATIONACC.BY <br />PLANS APPROVED BY <br />CITY OFEVEREFT <br />LOCAL SALES <br />PUBLIC WORKS <br />TAX CODE IS <br />roraL <br />30 <br />00 <br />3105 <br />WHEN PROPERLY VALIDATED <br />THIS IS <br />YOUR PERMIT <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDFIESS FILE <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />V <br />26527 <br />