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thc F.u�Tgreen <br />CITY OF <br />everett <br />259-8810 <br />C'�NSTRUCTI OI�! <br />PERMIT <br />PERMIT NO. _ 2 2 0 0 4 <br />O DEMOLITION ❑ COMBINATION P9 BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILADDRESS CITY 21P PHONE <br />Harlan Construction 4210 198th St SW #109 Lvnnwood aana 77 pqa� <br />TENANT MAILADpRESS CITY ZIP PHONE <br />ANCHITECTOROESIGNER MAILAD�RE55 QTY ZIP PHONE <br />James Anderson Desian 330 Davton St #6 Fr�m�*+d 980 0 776 6766 <br />GENERALCONTRACTOR MA0.qODRE55 GTY 21P PHONE LICENSE� <br />�V7ner HART.A(`T1 SSMQ <br />MECMRNICRLCONTRqCiOR MAIL/.DDRESS CIT/ ZIP PHONE LICENSE� <br />PLUMBINGCONTRRCTOR MFILRpDPESS CITY 21P PMONE LICENSE� <br />CLASS OF WORK <br />❑ ADDITION p ALTEqATION ❑ qEPAIR ❑ DEMOLITfON ❑ BUILDING RELOCATION <br />CONTRACT PRICE OF WORK: $ <br />WORN ANO SOUFRE FOOTAGE INVOLVED <br />New Construction <br />PROPOSEO USE OF BUILDING <br />CONTACT PEFSON AND PMONE N0. IF OTHER THPN ABOVE <br />Sinale familv residen e <br />LEGAL UESCRIPTION OF PROPERTY (SNOW BELOW OR ATTACM FOUR WPIES� <br />LOT - BLOCK � OF <br />See Attached <br />ADDRESS <br />1626 Puget Dr. <br />PLUMBINO <br />OR ITEM <br />LAVA70RV�W/ <br />SHOWER <br />KITCHEN SINK <br />URINAL <br />URINKING FOUNTAIN <br />FLOOR DRAIN <br />HOOF DRAINS - RAINLEADERS <br />SINK �SERVICE - BAR. ETC.1 <br />FRONTSETBACN <br />USE 20NE 20 <br />R-1 <br />V-N <br />SIZE OF BL�G <br />lli4 <br />OCCUPANCY�OAO <br />M. M <br />SUBTOTAI <br />PERMIT <br />flEARSETBACN <br />LOT nq AO <br />1Q,212 <br />ttPE OF [ONSfPOC710N PLiUAI <br />V-N <br />N0. OF STORIES <br />FIRE SPRINNIERS REO'0 <br />] YES (,� NO <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A/C — A/HNDLG UNITS — H.P. <br />� FORCED AIR SVSTEMS — B.T.U. M <br />UNITHEATERS—B.T.U. M <br />1 CLOTHES DRVEPS <br />2 VENTILATION FAN <br />1 RANGEMOOD <br />1 WATEF HEATER <br />WOODSTOVE <br />.L METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />S <br />S <br />VACANT 5 E <br />p VES ❑ NO <br />��'p'°`' AVOFONELIiNG <br />R-3 1 <br />BnSEMENT <br />7 YES GAMo <br />MEIGNT LIMITI TION <br />oY IPLANSAPPROVEDOV I CITY OF EVERETT <br />LOCALSALES <br />Jw. TAX CODE IS <br />3105 <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />PLAN CHECK NUMBER <br />89/22003 <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />SUBTOTAL <br />PENMIT <br />TOTALFEE <br />FEE <br />Basic <br />STATE BUILDING SURCHARGE <br />STATE ENEfiGY SURCHARGE <br />PUBLIC WORHS <br />PROPERLY VALIDATED THIS IS YOUR <br />ADDRESS FILE <br />GP] <br />22004 <br />0' <br />� <br />