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� y <br />C�� <br />H�� <br />Ft f] <br />'VH� <br />Hy <br />x <br />o�d <br />��g <br />��.yr n <br />'_7.H <br />H <br />� <br />g�y <br />f]❑Cti <br />l�l <br />�O� <br />'h�F°`.�'�" `�' CF�NSTRUCTION , <br />CITY OF C <br />everett PERM�T PERMITNO. 26S�U <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />���HEn niaanooaEss crtv zir wwne <br />Duane Mi11er 803 Olympic Blvd EVerett 98203 252-1880 <br />IENANi h1AILAU0PE5S CIiV ZIP CIIONE <br />RRCMIiEGi OR DE514NEB AIAIL AD�RESS CITY 11P CIIONE <br />John Mderson & Assoc 10620 NE Bth Bellevue WA <br />GENERALCONTRnCIOR MPIIADOR[SS CIi1' ZIP PMONE LICENSE• <br />Owner <br />MECHANICALCONTRI.CTOR MPILFD�R[SS CITY 21P PHONE LICENSE� <br />Piuuf�MGCf1NtRACTOR �IRILApDNE55 CITY Zlf FHONE I�CENSE• <br />CLR55 OF 1VOPK <br />❑ NEW � AD�ITION ❑ ALTERATION ❑ REPAIH ❑ DEMOLITION ❑ BUILDING RELOCATION <br />CONTACT PERSON NJO GHON[ NO IF OTH[R TMAN PDOIti <br />CONTRACTPRICEOFWORK:S Jewel hliller 355-7900 ext 269 <br />OESCRIpE W ORN AND SOUAfIL i00TAGE INVOLVED <br />Wood frame construction, new accessory building <br />vnoaoseo use ov ouauirvc, <br />Garage s workshop <br />�ecn� ocsc�aanorv or rnorcmr �snow oeiow on atrncH roun cories <br />wr �� a�ocre—ec Olympic View Addition <br />JOB A[lDnEsS <br />803 Olvmoic Blvd <br />PLUMBING <br />NO. TVPE OF FIl <br />WATER CLOSET �TOI�I <br />BATMTUB <br />LAVATORY�WASM�A`. <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />OISMWASHER <br />LAUNDRV?RAY <br />DRINKING FOUNTAIN <br />FIOOR ORAIN <br />BACKPLOW PREVENTERS <br />ROOF DRAINS — RAINLEP <br />SINK (SEFVICE — �AR, ET <br />�RON�SETpnCN <br />20' <br />USE20NE <br />sze o� o�oc <br />960 sf <br />or:cuvnr�cr�ono <br />MECHANICAL <br />OR ITEM FEE NO. TYPE OF':OUII <br />A/C — A�NNOIG UNITS — NP. <br />FORCED AIR SVSTEMS — B T I <br />UNIT HEATERS — B T.U. <br />GLOTMESDRVEP$ <br />VENTILATION PAN <br />qANGEMOOD <br />WATEfl MEATEF <br />WOODStOVE <br />METqL FIREPLACE 8 CHIMNE' <br />FIREPLACE INSERT n, <br />MEFTPUMV <br />GAS i'IPING <br />a� E%HAUSTFAN � <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />REAR SEtOAIX <br />5' <br />LOT AREA <br />13 600 sf <br />ALLfM'ANLE IVRO�CON51PUCf10N>GNI <br />V-N <br />NO OF SiO�IES <br />1 <br />r:nE svniH.�Ens nEo n <br />❑YES C�NO <br />JH <br />� <br />S <br />S <br />510[ SETOACK <br />5' <br />yn�qNT SItE <br />❑ YES � NO <br />lAN CNECK NUMpER <br />91/26838 <br />FEE <br />M EA <br />M <br />SUBTOTAL 5 <br />PERMIT S <br />TOTAIFEE 5 <br />FEE RELLIPT NO. <br />105._0 49620 <br />���^;",_° NooFOWEIuxGUNits BUILDMG <br />M-1 1 PLUM1IBING <br />onscniENr <br />❑ YES R7�lO 1dECHANICAI <br />r+eim�rur.u*nlior+ OTtiER pddnl Plan G <br />15' <br />STATE OUILDING SURCHARG <br />STATFENEHGYSURCHARGE <br />CITY OF EVERETT pUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS TOTAL <br />3105 �yHEN PFOPERLY V <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN qpUR[55 FILE <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />5 15,360 <br />THIS I <br />177J 00 <br />85 <br />50 <br />35 <br />✓ <br />268�8 <br />