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theEu�rgreen ^ C"`NSTRUCTlON � �' <br />C�TY OF <br />everett pER�AIT PERMITNO. _ 226�$ <br />259-88�0 <br />❑ DEMOLITION ❑ COMB�NATION �l BUILDING ❑ h"ECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILAOURE55 CITY ZIP PHONE <br />James Branstrom 5008 Nichols P1. Everett 98203 259-8727 <br />TENRNT MAII FOORESS CITY 21P FIIONE <br />ARCMITECT OR OESIGNER MAIL AUDRE55 CITY ZIP VMONE <br />GENERALCONTRACTOR MAILADDRESS CITY 21P PHOKE UCENSE• <br />Owner <br />MECMANICALCONTRACTOR MAILADDRE55 dTY ZIP PNONE LICENSE� <br />PLUMBING CONTRACTOfl <br />CLA55 OF 1VOFK <br />p ►<cW ❑ ADDITION <br />ICONTRACT PAICE JF WORK: $ <br />I OESCRI6E WORK AND SOUAflE i00TAGE INVOWEO <br />� New construction <br />MAIL q�Of1ESS <br />❑ ALTERATION ❑ REPAIA <br />PROPOSED USE OF B W 101NG <br />Single family residence <br />LEGnL DESCflIPT10N OF PPOPERTY (SHOW JEIOW OR ATTACH FOUP�COPIES� <br />�or 12 BIOCK _ OF Triada Granada <br />JOB ADDR:55 <br />PLUMBING <br />NO. TYPE� <br />j WA7ERCLOSET <br />2 BATHTUB <br />S I LAVATORV/WA: <br />1 DISHWASMER <br />1 LAUNDRVTRAV <br />1 CLOTHES WASHER <br />URINAL <br />DRINNING fOUNTAIN <br />FLOOR DRAIN <br />1 BACKFLOW PREVENTERS <br />ROOF ORAINS — fiAINLEADERS <br />SINK 1SEHVICE — BAR, ETC.) <br />SUBTOTAL f <br />PERMIT f <br />2� <br />F1J�1 <br />25 <br />lYli0iC0119RUC710NRlLNYaBIE ttifOfCONSiPtICiIONACiUi <br />V-N V-N <br />S12E OF �LDG NOAF STONIES <br />2526 + 600 GAR 1 <br />OCCUPANCY LORO FIRE SPPINNLEqS PEO'D <br />N/A ❑ YES [� NO <br />REASONFORSPnINNLERS <br />nCC. OY <br />M.M. <br />VACRNT SITE <br />� YES ❑ NO <br />°`�'`"'•"�`' NO.Of �NiIUNG <br />cnour <br />VES ❑ NO <br />IIEIGHT LIMRATION <br />�a� <br />„�"""`"" I CITY OF EVERETT <br />LOCALSALES <br />B � TAX CODE IS <br />3105 <br />�ERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN <br />180 DAYS OR CEASES FOq MORE THAN �80 DAYS. <br />CITY <br />❑ DEMOLITION <br />VHONE <br />❑ BUILDING REIOCATION <br />CONTACT PERSON AND PHONE NO. IF OTMER iMAN ABOVE <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />A/C — A/HNOLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />UNITHEATERS—B.T.U. M <br />'LOTHESDNVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER MEATER <br />WOODS70VE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PLANCNECKNUMBEP <br />b�/22628 <br />FEES <br />SUBTOTAL s <br />PERMIT f <br />TOTALFEE t <br />8izs���i. so :o � <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />OTHER plan Ck <br />STATE OUILDING SURCHARG <br />SI�ATFENERGVSURCHhRGE <br />PUBUC WORKS <br />PROPERLY <br />ADDRCSS FILE <br />1171-5 <br />p�� <br />EL[2G_._ <br />P��ec.— <br />ItGl.n <br />FI N fH <br />E SRCH <br />FEE <br />226��; <br />9 <br />