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CITY OF EVERETT <br />� �ONSTRUCTION � `�� <br />PERM�T PERMITNO. 27�07 <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �.1 MECHANICAL ❑ PLUMBING ❑ SIGN <br />pyy��Eq AtAILADDFE$5 CITY Z�P PMONE <br />Jacob VanDyke 1609 D1cDougall Ave Everett 98201 258-1457 <br />TENANT MRILADDRE55 CITV 21P PMONE <br />ARCMITECTOROESIGNER MAILADDRESS CITV 21P PMONE <br />GENERALCONTPACTOR 6�AILAODRESS CITY 21P �HONE LICENSE• <br />MECMANICALCONTRnGiOR MAI�A�DR/,S CITV ZIP PHONE LICENSE• <br />Valley Natural Gas 2605 D1cDougall Everett 98201 259-5492 VALLENG153L1 <br />PLUMBINGCONTRACTOR MAILp0�RE55 QTY 21P PMONE LICENSE� <br />❑ NEW <br />❑ ADDITION <br />CONTFACTPRICEOFWORK: S 1150 <br />DESLRIBE N'ORK AND SOUARE FOOTAGE INVOLVED <br />Install furnace <br />PROPOSEO USE 0= BUILDING <br />Single family res <br />LEGAL DESCRIPT'ON OF PROPEPTY �SHOW OELOW <br />LOT_ 01 ;iCK _ OF <br />�ooaooaEss <br />1609 McD <br />PLUMBING <br />NO. 1 <br />WATER q <br />BATHTUB <br />$1 ALIERATION <br />OF FIXTURE OR ITEM <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />F�OOR DRAIN <br />�ACKFLOW PREVENTERS <br />ROOF DRAINS - RAINLEA[ <br />SINK ISERVICE - BAR, ET( <br />PRONTSETO/ <br />USL lONE <br />ir FC OF GO`�STI <br />s�zc oF o�o� <br />OCCUPANfY I <br />aensor+roa <br />SUB TOTAL <br />ALLOWAOIE I n'PE OP <br />�TORIES <br />FlR[ SPRIPINLEF: <br />❑ YES ❑ NO <br />FOUR COPI[5� <br />FEE <br />❑ REPAIR ❑ DEMOLITION ❑ BU�LDING RELOCATION <br />� <br />5 <br />5 <br />SiDE SE 1 �AGN <br />V�CAN7 SIT[ <br />❑ VES ❑ NO <br />0.�i�pa NOOF�IYEWNG <br />OASEM6NT <br />❑ YES ❑ NO <br />HEIGHT LIMITATION <br />ncc or awr+snar�oveou. I CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />3105 <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />ANp PNONE N0. IP OTHEF iHAN A60V[ <br />Q9/30/91 ��04FhS ODOf�HD.>.1 <br />{ <br />NOQ0�7807 <br />!{OOQ�784° <br />MECHANICAL C4ECf; <br />NO. NPE OF EOUIPMENT <br />NC - MiNDLG UMITS - H.P. <br />FORCEDAIRSYSTEMS-B.T.U. MEA. <br />UNI7HEATERS-O.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATER NEATER <br />WOOD STOVE <br />METAL FIREPLACE � <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />S <br />PLAN CHECKNUM�GR IFEE <br />FEES euaumucw� FEE <br />VALIIATION <br />1�i <br />BUIL�ING S <br />PLUMBI4G <br />MECHANIC�L Sj ( <br />OTHER <br />STATE BUtLDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PU�LIC \NORKS <br />TOTAL SS.00 Z3 <br />WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT <br />ano�aEss Fu F 2 7 8 0 7 <br />