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�Hcn <br />HTZ <br />hC W <br />1-37D <br />ai H 'i1 <br />fn H <br />OH <br />Hag <br />yzyH <br />rHH <br />co <br />gdCo <br />z H3 Tn <br />H3 0 CO <br />"1eE"'gree" <br />CITY of t_ ONSTRUOTION <br />everett PERMIT PERMIT NO. 26259 <br />259-8810 <br />O DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING 0 SIGN <br />OWNER MAIL ADDRESS CITY 21P PHONE <br />/PJ. <br />SmitSmith630lowb SA? <br />Lane Everett, WA 98201 252-3567 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />e . . <br />OR DESIGNER MAR ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICPL CONTRACTOR IAAIL AD DRESS CITY ZIP PHONE LICENSE <br />nt v <br />Gas Equipment Co. Inc. 1625 E. Marine View ur. f:vereLc nAL �DavA ..�,..,...,..-_• <br />.un ennaccc CITY ZIP PHONE LICENSE• <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR [I DEMOLITION ❑BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO. IF OTHER THAN ABOVE <br />CONTRACT PRICE OF WORK $ 200.00 <br />DFSCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />PROPOSED USE OF BUILDING <br />Sin le Famil Res <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT — BLOCK __ OF — <br />.•OD AODRE`s' <br />(T L Q <br />AAFCHANIf'.AL <br />PLUMBING <br />'"'--"---- <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />A/C — A/HNDLG UNITS — H.P. <br />WA i ER CLOSET (TOILET) <br />FORCED AIR SYSTEMS —BT.U. MEA. <br />BATHTUB <br />B.T.U. M <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />CLTHEOTHESS <br />SHOWER <br />VENTILATION FAN <br />KITCHEN SINK A DISP. <br />RANGE HOOD <br />DISHWASHER <br />WHEATER <br />LAUNDRVTRAY <br />WOOD STOVE <br />CLOTHESWASHER <br />_ <br />METAL FIREPLACE SCHIM <br />URINAL <br />— <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />GAS FIPINO <br />BACKFLOW PREVENTERS <br />` <br />EXHAUST FAN <br />ROOF DRAINS — RAINLEADERS <br />V <br />SINK (SERVICE— BAR. ETC.) <br />SUBTOTAL f <br />n <br />SUBTOTAL $ <br />PERMIT f <br />PERMIT <br />f <br />TOTALFEE <br />f <br />TOTALFEE <br />SIDE <br />f <br />SETBACK <br />PLAN CHECK NUMBER <br />PEE <br />RECEIPT NO <br />FRONT SETBACK <br />REARSETBACK <br />BUILDINGLCODE <br />ION <br />FEE <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />❑ YES ❑ NO <br />BUILDING <br />S <br />TYPE OF OBNSTRUCigN ALLDNABIF <br />ttR OF CBNSTRULiXNACNAI. <br />NB DF DWELLING UNITS <br />PLUMBING <br />— <br />SIZE OFBLOG <br />NO OF STORIES <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />OCCUPANCYLOAD FIRE SPRINKLERS REDD HE.'HT LIMITATION <br />OTHER <br />❑ YES ❑ NO <br />STATE BUILDING SURCHARGE <br />REASON FOR SPRINKLERS <br />STATE ENERGY SURCHARGE <br />APPLICATIONACC.BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />PUBLIC WORKS <br />TOTAL <br />30 <br />00 <br />TAX CODE IS <br />3105 <br />WHEN PROPERLY VALIDATED <br />THIS IS <br />YOUR PERMIT <br />0 <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDRESS FILE <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />26259 <br />