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5 � htl <br />[s� <br />H <br />� � y <br />H�� <br />k n <br />H �I <br />� M � <br />N <br />H <br />�zp <br />HC <br />��g <br />iij Y (j <br />t"y� <br />HH <br />g" <br />C� C N <br />� <br />H� <br />HOa� <br />Uu•F:rrrqrrrn C -�)NSTRUCTION <br />��„-�� C <br />everett PERMIT PERMIT NO. _�� ��! � <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ;O MECHANICAL ❑ PLUMBING ❑ SIGN <br />���H�� rananooness ci�r zu+ vHONE <br />Hveret[ Housing Authoriry 14th & PopLar Gverett 98201 258 9222 <br />.� iENANi RIRILPODBE55 CITY :JP VMOt![ <br />GONTPACTOR <br />MPIL A�ORC55 <br />AIAIL <br />pTY <br />CITY <br />21P PMONE <br />Zip FIIONE LICENSE• <br />M[CHANICALCON1�tACiOR MAILAOORE55 CITY 21P �NONE LILENSE+ <br />Corby, Inc 1471 127th Pi NE Bellevue 98005 646 3471 CORBY**2G205 <br />PLUMOINGGONLRRCTOR MAiLAD0�E55 GtV ZiP VMONE IiCENSE• <br />anss or wonrc <br />❑ NEW � ADDITION <br />CONTHACT PRICE OF WORK: S <br />ALTERATION <br />❑ HEPAIR ❑ DEMOLITtON ❑ BUILOING RELOCATION <br />CONTACT PERSON AND PI10NE NO If-07�fi0.T11011 AB�w�FM OOORH3633 �t=k�t�k <br />�� 1L/YU <br />OESC�iOE�VGNNANO50UFREfOOTPGEiNYOLVED �Q�JbL <br />aen�acs_r.a f � Hcnr its_m <br />H00025563 <br />�ru tis_ntL <br />raovoseo use ov ow�oirvc � <br />�� . f �, wcru tSS_m <br />LEGAL OESLRiPTION Oi PROPERTV ISHO\Y �ELOVI O� ATTACN fOUP COPIES) YfYVf .�5� <br />O�rl8rlVu:. <br />LOT - BIOC✓ - OF ��y��� r(t ;� � <br />�ItJtll125JOO <br />�f ' � <br />�cru aSs m <br />qD0025567 <br />�cru a� m <br />�oenooaEss (��}; j330.pp <br />PLUMBING <br />NO. TYPE OF FII(TURE OH <br />WATER CLOSET (TOILET� <br />BATMTUB <br />LAVATORV(WASMBASIN) <br />SHOWER <br />KITCMEN SINN 8 OISP. <br />DISHWASMER <br />LAUNDRYTRAY <br />CIOTHES WASMER <br />URINAL <br />�PINNING FOUNTAIN <br />FLOOfl DRAIN <br />BACKFLOW PREVENIERS <br />ROOF DRAINS — RAINLEAOERS <br />SINK ISERVICE — BAR. ETC � <br />fRONTSETOF� <br />USE 2UNE <br />nrc or rovsrA� <br />54[OFOLDG <br />OCCtI�'.1NCY I <br />r��.,sa+�oN <br />SUBTOT�L S <br />PEHMIT f <br />TOT�LFEE 5 <br />REAR SETpRLK 5 <br />LOTAREA � <br />C <br />ntt ov �avsrxucnov:auni <br />Oi STORIES <br />fIPE SPRINNLERS REO D <br />] YES ❑ NO <br />SETOACN <br />YES ❑ NO <br />MECHANICAL <br />TYPE OF EOUIPMEN7 <br />A/C — A�MNDLG UNITS — M P. <br />FORLED AIR SYSTEMS — 8 T.0 �� <br />11NIT HEATEPS — � T.U. M <br />CLOTMESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WAiERHEATER <br />WOO�STOVE <br />A1EiAL FIREPLACE 8 CHIAINEY <br />FIFE?LnCE INSERT <br />MEAT PUMP <br />GAS PIPING <br />E%MAUSTFAN <br />SUBTOTAL <br />PEflM1T <br />TOTAL FEE <br />PLAN CMECK NUMBER FEE <br />FEES eu��o <br />uunS BUILDING S <br />PLUMBING <br />pASEMENT <br />❑ YES ❑ NO <br />HEIGHT LIAIITI•TION <br />ncc er IPLRNSAPPROVEOOV I CITY OF EVERETT <br />LOCAL SALES <br />TAY. GODE IS <br />3105 <br />PERMITS EXPIRE �F WORK IS NOT COMMEN(:ED WITHIN <br />1B0 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHARGE <br />PUPLIC WOPKS <br />•1;1:1�:1 <br />A7URESS FILG <br />TED <br />f <br />� <br />FECE�PT ND. <br />��;1�)0� <br />