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CITY OF EVERETT <br /> � '``CONSTRUCTION� � <br /> PERMIT PERMITNO. 27 �� 0 <br /> 259-8810 <br /> '�] 7EM0:_IT.ION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br /> OWNER MAILADDRE55 CITY 21P PMONE <br /> Emily Sacks 1906 Rockefeller Everett 98201 252-1516 <br /> TENANT MAI�ADORESS GITY ZIP PNONE <br /> ARCHITEGTORDESIGYEP MAILAD�RE55 LIiY ZIP PMONE <br /> GENERALCONiRnCTOR MAILAD�RE55 CIiV 21P PHO�E UGFNSE� <br /> MECHANICALCCNIRACTOR M4ILADORESS CIiY ZIP PHONE LICENSE• <br /> Valley Natural Gas 2695 NcDougall Gverett 98201 259-5492 VALLENG153L1 <br /> PIUMBINGGONTRnCTOF MAI.ADDRESS CITV 21P PMONE LICENSEr <br /> ClASS OF WOPK <br /> ❑ NEW ❑ ADDITIUN ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING REIOCATION <br /> CONTACT PERSON ANO PHONE N0.IP OTMER TMAN ABOVE <br /> CONTRACTPRICEOFWORK: S1,593 <br /> DESCRIBE W ORK ANO SOUAPE FOOTAGE INVOLVED <br /> Install furnace & Hot water heater <br /> PROPOSED USE OF BUILDII:G <br /> SFR _ <br /> LEGAL DESCRIPTION OF PROPERT\"(SHOW DELOW OfiATTACN FOUR COPIES� <br /> LOT_BLOCK_OF . <br /> l._•L <br /> � <br /> Mf.CHL � ti55.00 <br /> JOOADDRE55 L` �'�` <br /> 1906 Rockefeller MECH �55.00 <br /> PLUMBING MECHANICAL �Q00^c7�81 <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EOUI ., � � FEE <br /> WATER CLOSET(TOILET) NC-A'HNDLG UNITS-H.P. <br /> BAThITUB I FORCEDAIRSVSTEMS-8.T EA. n � _ <br /> LAVATORY�WASHBASIN� UNIiHEATERS-B.i.U. _ �� <br /> SHOWER CI�rN[�Gfu cH5 <br /> KITCHEN SINK 8 DISP. VENTILATION FAN <br /> DISHWASHER l7ANGE HOOD <br /> LAUNDRVTRAY 1 WATER HEAiER <br /> i.LOTNES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CMIMNEY <br /> DRINKIN(;FOUNTAIN FIREPL4CE INSEFT <br /> FLOOR DRAIN HEAT PUIdP <br /> � BACKFLOW PHEVENTERS Z GAS PIPING <br /> flOOF DRAINS-RAINLEADERS E%HAUST FAN <br /> SINK(SEFVICE-�AFl.ETC.) <br /> SUBTJTAL 5 SUBTOTAL 5 4U OO <br /> YERMIT 5 PERMIT 5 <br /> TOTAL FEE S TOTAL FEE 5 S S OO <br /> fFONT SETonCK REnn 3ETOnCK Si�[SEiOnCK P�.AN CHECK NUM6EP FEE RECEIPT NO. <br /> USE 20N[ LOT AREA VACANT Sit@ BUILOING CODE <br /> FEES VALUATION FEE <br /> ❑V[5 ❑NO <br /> TVPEOFLONSiRUCT�NRLIOW>BLE TYPEOFCONSTPUCTIONACTUAL ��n�e�' NOOFp'SE11i90U4ii5 BUILDING S <br /> PLUMBING <br /> 5¢EOFBL�G. NO.OFSTORIES �ASEIdENi — <br /> ❑vES ❑No MECHANICAL SS OO <br /> OCCUPRNGVl040 FIRESPRINKLEFSFEO'D FIEIGNTLIM!TATION OTHER <br /> ❑YES ❑NO <br /> aEA50N FOr+SPRwNLeRS STATE�UILDING SURCHARGE <br /> STATE ENERGY SURCHAfiGE <br /> APPLICATIONACC.DY PLANSAPPROVS�AY CITY OF EVERETT <br /> LOCAL SALES �'UBUC WORHS <br /> TAX CODE IS TOTAL 55 00 <br /> 3105 <br /> WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT <br /> � <br /> PERMITS EXPIRE IF WORK IS NOT COMME�CED WITHIN 'Z l G �j �) <br /> 780 DAYS OR CEASES FOR MORE THAN 180 DAYS. f' """ '�' ' ' '_ <br />