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fheF.oergrecn ^ 1 �NSTRUCTION ��' ^� <br />CITY OF q <br />everett PERMIT PERMIT NO. 2� � I� <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILADDRESS CITY ZIP PHONE <br />Joanie ithoden 5607 Highland Rd. Everett, 98203 353-5187 <br />TENANT MAIIA��RE55 CITY ZIP PHONE <br />OESIGNER <br />GENEfiRL GONTRPGTUN <br />Rocky Gibbs Const. <br />MECHANIC�LCONTR�CTOR <br />MAII AD�RESS <br />MNII ADDRESS <br />PO Box 6141 <br />AIAIL AD�RES$ <br />CITY ZiP PF:ONE <br />piry 21P PHONE IICENSE� <br />Lynnwood, 98036 745-3178 ROQCYGC138P2 <br />CITY 21P �HONE IICENSE• <br />PLUMBiNGCONTRRGTOR MAILApDRE55 CITY ZIP �HONE LICENSE� <br />CLASS OF WORN <br />❑ NEW ❑ ADDITION 0 ALTEHATION O REPAIR ❑ UEMOLITtON ❑ BUILDING RELOCATION <br />I CONTACT PERSON AND PMONE NO IF OTHER THAN ntlOve <br />CONTRACT PRICE OF WOAK: $ ROC�cy G1bbS 745-3178 <br />Addition 429 S.F. <br />PROPOSED USE Of BUILDW G <br />SFR Bedroom/Rec. Rm. <br />LEGAL DESCRIPTION OF PqOPEPTY (SHOW DELOW OR ATTACM FOUR COPIES� <br />LOT - �LOCR - OF <br />JOO <br />PLUMBING <br />NO. TVPE OF FI%TURE OR <br />WATER CLOSET (TOILeT� <br />9ATMTUB <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASHEH <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />F)p0° ORP.�NS - FAINLE/ <br />SiNK ISERlICE - BAR, El <br />iRONi5ET8ACK <br />20' <br />USE ZONE <br />CONSiFUCiWN ALIONABIE <br />429 <br />OCCUPPNCYL <br />REASONfORSPRINNLERS <br />SUBTOTAL <br />PENMIT <br />TOTAL FEE <br />FEARSE1BnCR <br />20' <br />LOT AREA <br />A}[% V-N <br />NO OF STORIES <br />FIqE SPRINNLERS REOD <br />] YES ❑ NO <br />MECHANICAL <br />FEE NO. TYPE OF EOUIf <br />A/C - N/HNDLG UNITS - H.P. <br />PORCED AIR SYSTEMS - B T.l <br />UNIT HEAIERS - B.T.U. <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOG <br />WATERHEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIM ' <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />f <br />S <br />SIOE SET�RCN <br />6' <br />VRCANT SITE <br />❑ YES C� NO <br />��� rro o� ox� <br />R-3 1 <br />VES ❑ NO <br />MEIGNT LIMITATION <br />eo� <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODF IS <br />3105 <br />PLAN CHECI( NUI <br />89/23115 <br />M EA. <br />M <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />FEE <br />111.15 <br />BUILDING S 17 � 589 <br />PLUMBING <br />MECHANICAL <br />OTHER p],yn check <br />STATE BUILDING SURCHARGE <br />STATE ENERGV SURCHAFiGE <br />PUBLIC WORKS <br />TOTAL <br />WHEN PROPERLY VALIDATED TI <br />FEE <br />� <br />S <br />S <br />PECEIPT NO. <br />16187 <br />189 00 <br />11 70 <br />4 50 <br />205 20 <br />IS YOUR PERMIT <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDRESS FILE ��� 1� <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />