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`�E"��'� �' CC":'�STRUCTION .� '� <br />evese� PERMIT PERMITNO. 269J I <br />❑ DEMOLI710N ❑ COMBINATION ❑ BUILDING X�I MECHANICAL p pLUMBING ❑ SIGN <br />OWNEP M,11L qDORE55 F��ONE <br />Mark Loretzen 823 Olympic Blvd. Everett 98203efY 258i2978 <br />TENRNT MAILAD[1RE55 CITY ZIP PMONE <br />�RCNItECT OR <br />GENEliNL <br />M1IAII A�DRE55 <br />MAIL ADDRESS <br />Wi� <br />cin <br />Z�P PHONE <br />21F PMONE LILENSE• <br />MECNANICAL CONiRRGTOR � MAIL ApDRES$ CITY Z�p <br />PMONE �ILENSE• <br />N.W. Water Heater 31�0 Hi11 St. Everett 98201 259-5331 NORTHWH*103R2 <br />PLUMBINGCONTRRCTOq AIAILqpDRE55 CITY 21P PHONE <br />UCENSE • <br />CLA55O� WORK <br />❑ NEW O ADD1710N ❑ ALTERATION <br />CONTRACT PRICE OF WORK: S 1� 200.00 <br />DESCRIBE WORN ANDSOU/RE FOOTAGE INVOLVED <br />Install gas furnace & water heater <br />PROPOSED USE OF 9UiLDING <br />Single family residence <br />� REPA�p ❑ DEMOLITION ❑ BUILDING RELOCA'� ION <br />CONTACT PERSON OND PHONE N0. IF OTM[R TMAN ABOVE <br />ior _ eiocK _ oc / <br />a000zs9s� <br />HECH 555.00 <br />PLUMBING <br />NO. TYPE OF <br />WATER CLOSET (T( <br />BATHTUB <br />LAVATOFV(WASHF <br />8 DISP. <br />CLOTHES WA; <br />URINAL <br />DRINKING FOI <br />FLOOR DRAIN <br />ROOF DRAINS — <br />SINK 1SEHVICE — <br />USE20NE <br />iVq:O( CONSiRUCTION ALLON'ABtE <br />szeove�oc <br />OCCUPANCYl010 <br />acnsoH roe srair�K�ens <br />MECHANICAL <br />ITEM FEE NO. TYPEOFEOUIPMENT <br />A/C — A/MNDIG UNITS — HP. <br />1 PORCED AIR SYSTEMS — B.T.U. M EA. <br />UNITHEATEPS—B.T.0 M <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />1 WATER HEATER <br />WOOD STOVE <br />METAL FIqEPLACE d CMIMNEV <br />FIREPLACEINSERT <br />HEA7 PUMP <br />1 GAS PIPING <br />E%NAUSTFAN <br />SUBTOTAL S <br />PERMIT s <br />TOTALFEE : <br />oqSET�nCK Si�ESETpRCN <br />lOT qREP <br />ttl[ Oi CONSiPI1CtI0N ACNAL <br />NO OF STORiES <br />FIFE SPqINftLEPS PEOD <br />7 VES ❑ NO <br />C�NT SITE <br />YES ❑ NO <br />'�ry^,'w `' NO OFONtLUNG <br />�ASEMENT <br />7 VES ❑ NO <br />HEIGNt �iMiTATiON <br />ncc ev IP(ANSAPPflOVE�BV I CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />3105 <br />PLAN CHECKNUMOER <br />SUBTOTAL <br />PEPMIT <br />TOTALFEE <br />FEE <br />BUILDING $ <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STA7E OUILDING SURCNARGE <br />STATE ENEFGV SU(iCHARGE <br />PUBLIC WORNS <br />TOTAL <br />WHEN PROPERLY VALI[ <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. ADDRESS FILE <br />FEE <br />� <br />S <br />f <br />RECEIPT NO. <br />IS YOUR <br />55 � 00 <br />55 � 00 <br />