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1he�Cergre�F �' �'^ONSTRUCTION � <br />ev�rett PERMIT PERMITNO. 23621 <br />259�8810 <br />O DEMOLI1lON O COMBINATION ❑ BUILDING ❑ MECH1lVICAL ❑ PLUMBING ❑ SIGN <br />OKNER R1All ADDRC.55 CI'Y ZIP CMONE <br />Darrell 9urden 10409 4th Ave. W. Everett, 98203 353-5461 <br />1CNM1Ni MNILADDRE55 CITV 11P PMONE <br />MCIIITECTOROESI.NE� AIA�L\ODRESS C�TY ZIP PIIONE <br />GENERAL CONTPACTOR MNL�IDDRE55 CITY ZIP PMONE UCENeE• <br />AIECIIINICAI.WNTii4CT0� MAII,�OORE55 CITV ZIP PIIORE UCENSE� <br />Valley Nat. Gas 2605 hlcDougall Everett, 98201 259-5492 V.1LI,ENG153LI <br />PWAIOINGCONTHACTOR �dAILA0DRE55 CITY 21P {'HONE LICENS[� <br />CLASS OF N'OFK <br />❑ NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ DEMOLITION �J BUILDING RELOCATION <br />CGNTRACT PHICE GF WORK: S 3�%OO <br />0[SCi'ip[ WORK nND EOUt�qE FOOTnG[ iNVGLVEO <br />Install furnace & �vater tank <br />anorosEo usE or ouuoiHc <br />LEGAL DESCR�Pt10N OF PPOPERiV �SN01e pELOP1 OR nii 4CH �OUR CO�'iESI <br />LOT _ OLOCN _ OF <br />JO�A�OFESS <br />10904 9th Ave. W. <br />PLUMBING <br />NO. TYPE OF FIXTURE O <br />WATER CLOSET �TOILET) <br />BATHTUB <br />LAVATOfiV �\YASH OASIN) <br />SNOWER <br />KITCHEN SINK 4 DISP. <br />DISHWASHEf7 <br />LAUNDRYTPAV <br />CLOTNES WASNER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BAGKFLOW PR[VENTERS <br />ROOF DRAINS — RAINLEA�ERS <br />SINK �SERVICE— DAR, ETC.� <br />I15C ZON[ <br />RV,�_OI! FOR SPRMKL[RS <br />SUBTOTAL <br />PEHMIT <br />TOTALFEE <br />R[h!1 SETpnCN <br />LOTAREA <br />uo ovsronies <br />fiRE EPRMKLERS REO-� <br />O �ES ❑ NO <br />CONTACT FERSON ANO PI!JN[ NO IP OTNER THAN A[I�VE <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />AiC — A�NNDLG UNITS — HP. <br />FORCED AIR SYSTEMS — B TL. M EA. <br />UNIT HEATERS — B.T.U. M <br />CLOTHES DRVEFS <br />VENTILATION FAN �� <br />RANCEHOOD <br />1 V:ATER HEATER �+ n <br />1Y00D SiOVE ��u <br />_ M[TAL RPEPLACE 8 CNIM�1I�j'n�piF^y� <br />FlqFP�ACEINSENT <br />HEAT PUMP � <br />? GAS PIPING <br />EXHAUSTFAN <br />1 Florizontal (75hi BTU) <br />�SUBTOTAL <br />5 PEPA7IT <br />5 TOTALFEE <br />SIUESETUnCK PLANCHECKNUMOER P[E <br />VAGr1NT SIiF. <br />❑ ves ❑ No FEES <br />a�;;;;';,K'Nuoro'.KtuNGUNiis BUILDING S <br />PLUMDING <br />AAS[MENT <br />❑ YES ❑ NO ��ECHANICAL <br />HEicm uburnnoH OTHER <br />STATE CiUILDING SURCHARGE <br />_ STATEENERGI�SURCHARGE <br />CITY OF EVERETT <br />LOCAL SALES PUBLIC WORHS <br />TAX CODL= IS Tora� <br />_ 3105 �,�,�HFN aanar-ai v vni i <br />PEAMITS EXPIRE IF WOF:K IS NOT COMMENCED WITHIN qpDili=Sti FILL <br />tA0 UAYS OR CEASES FOR MORE THAN 180 DAYS. <br />FEE <br />�S <br />RECEIPT NO <br />FEE <br />7S <br />THIS IS YOUR PERMIT <br />