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"�E°��� ^ C7NSTRUCTION " '~ <br />everett PERMIT PERMITNO. Z6O41 <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING CY MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MqILAO�RESS CITY Z�p PIIpNE <br />Kirke Sievers 710 NIles Ave. Everett, WA 252-0710 <br />TENRNT M1IAILADDRESS CITY pip PHONE <br />�WI1C'Y <br />ARCNITECTOFDESIGNER MAILADDRE55 CITY Zlp PHONE <br />GENEPRL CONTHACTOR MAIL qODRE55 CITY ZIP PHONE LICENSE � <br />MECMANICALCONiRACTOR MAILAD�FESS CITY ZIP f`NONE LICENSE� <br />Valley Nat. Gas 2605 McDougall AVe. Cverett, WA 259-5492 VALLENG153L1 <br />PLUMBiNGCONTRACTOR MA4qDDnFSS CITY ZIP PNONE LICENSE� <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION [�ALT[1iATION ❑ REPAIR ❑ DEMOLIT,ON ❑ BU�LDINGRELOCATION <br />CONTAGT VERSON ANO PHONE NO IF OTNER TMAN ABOVE <br />CONTRACTPRICEOFWORK:S SbS.00 _ <br />DESCRIBE WORK ANO SOOARE FOOTAGE INVOLVED <br />Install Conv. Burner & AWH <br />YHOPOSEO USE OF OUiIUING <br />Single Family <br />LEGAI OESCRIPTION OF PROPERTY �SMOW BELOW OR ATTACH FOUR COPIES) <br />LOi- BLOCK_ OF <br />JD3 ADORE55 <br />710 Niles Ave. <br />PLUMBING <br />NO. TYPE <br />WATER CLOSET <br />BATHTUB <br />LAVATORVIWA: <br />UUNDRV TRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DflAIN <br />BNCKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADE <br />SINK (SERVICE — BAR. ETC.) <br />USEZONE <br />iYiC OiLONSiNOCP�NAIIOLYA <br />Si2E OF OLDG <br />OCCUPANCYLOAD <br />ViEA50N fOR SPRINRLEPS <br />APPLICATION ACC OY <br />SUBTOTAL f <br />PERMIT S <br />TOTAIFEE f <br />REARSETORCN S�DESETBPCK <br />LOT AREA <br />IV14 OF LONSiNUCiION ACi11AL <br />NO. OF STORIES <br />FIRE SPRINKLERS RW'0 <br />] VES ❑ NO <br />1N5 APPROVED BY <br />MECHANICAL <br />FEE NO. TYPE OF EI <br />ac - aHNo�c uNirs - <br />FORCED AIF SVSTEMS — <br />UNIT HEATERS — 8 T.U. <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />I WATEfl 11EATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIA <br />fIREPLACEINSERT <br />HEATPUMP <br />Z GAS PIPING <br />EXHAUSTFAN <br />NUMBER <br />11l28/90 4:25Pt1 OOORN4726 ##�t 1 <br />SUB TOTAL <br />PEflMIT <br />TOTALFEE <br />FEE <br />❑ vES ❑ NO FEES <br />�;,�'„'�` NOOFONEWNGUNrtS BUILOING S <br />PLUMBING <br />�ASEMENT <br />O �ES ❑ NO MECHANICAL <br />HEIGHTLIMITATION OTHER <br />STATE BUILDING SURCHARGE <br />ST�TEENERGYSURCHARGE <br />CITY OF EVERETT <br />LOCAL SALES P��BLIC WORKS <br />TAX CODE IS <br />3105 <br />PERMITS EXPIRE IF WORK «NOT COMMENr.ED WITHIN <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />AD[JRE;iS FILE <br />PA <br />LV VALIDATED THIS <br />FEE <br />f <br />RECEIPT NO. <br />FEE <br />r. <br />'(�(l�, <br />