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fheF.rcrgrrrn -� �,�ONSTR�JCTIOf�� -�� <br />CITY OF <br />everett PERMIT PERMITNO. _ ����'� <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION f�] BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />01VNER U.AILA�ORE55 CRV ZI� PIIONE <br />Jerald 5 Dennise CooFer 8885 5502 2nd nve. Everett, WA 98201 253-5900 <br />TEN�INT .- �AAiLADDRE55 CiTv 2iP PHONE <br />AFC�nTECTOPO[SIGNER MAILADDRE55 CRV ZiP PHONE <br />GENERRL LONTP�GTOR �IAiL /D�RESS CitY ZiP PHONE LILENS[ • <br />652-74 G ** � <br />MECN4NICALCONTRACTOR MAIIPDORE55 GiY ZI� Ff10NE LICENSE� <br />PWMOING <br />AIAIL P�ORE$$ <br />IIP PHONE �ICENSE � <br />CLR55 OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION C� NEPAIR O DEMOLITION ❑ BUILDING RELOCATION <br />CONTAGT PERSOY ANO FHONE NO IF OTMER TNAN AOOVE I, <br />CONTRACT PRICE OF WORK- S 7 000 00 bf & M Contractinq 652-7496 _i <br />D[SCNpE WORN ANO SOU��E LOOTAGE INVCLVEO <br />Re air foundation on 800 Sr rouse <br />I <br />PROPOSED USE OF OUtL�ING � <br />Sinqle Residence <br />L[GAL 0[SCRIPTION OF �ROPERTY ISMOW �ELOW OR AiT�CH lOUii COVI[51 I <br />lOT - OLOIX - Of <br />JO�AOORE55 <br />SSl19 c 9��j 7�v(+. <br />PLUMBING <br />NO. TYPE Of FI%TURE OR ITEM <br />WATER CLOSET �TOILET) <br />BATHTUB <br />LAVATORYIW�SH DASIN) <br />SHOWER <br />KITCHEN SINN fl DISP. <br />OFINHING FOUNTAIN <br />FLOOR DR�IN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEA <br />SINK (SERVICE — BAR, ET <br />USE ZONE <br />ttIE OF CONSiNtIC110N ALlU4VAl <br />SiZE OF ULDG <br />FDN Onlv <br />OCCUPnNCYLOAO <br />N/n <br />qEA50N F0� SPRINNLGRS <br />qPPLICAiION ACC �Y <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />PEARS[TBACN <br />AREA <br />IY{E OF�ONSiNULtiON AC1V0.l <br />V-N <br />NO OF STO�iIES <br />FiRE SPR�NNLERS REO D <br />❑ VES CjNO <br />N$ APPROVED �\ <br />4 W <br />MECHANICAL <br />FEE NO. TYPE OFEOUIPI <br />fe'C — AMNDLG UNITS — HP. <br />FORCED AIR' YSTEMS — � TL. <br />UNR HEAiE�S — B TL <br />CLOTHESORVERS <br />VENTILATION FAN <br />RANGEMOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FlF7EPLACE 8 CHIMNEI' <br />fIREPLACEINSERT qQ� <br />H[AT PUMP E:LI <br />GAS PIPING <br />EXHAUST FAN �: ! <br />� <br />S <br />S <br />SIDESETOACk <br />'FCANT 9TE <br />] VES ❑ NO <br />�;�a,�;« eaovowFwrvc <br />R-3 1 <br />YES f�7 NO <br />ME�GNT L�MITAT�ON <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />3105 <br />Sl1B TOTAL <br />PERMIT <br />CHECKNUMDER IFEE <br />M EA <br />M <br />OUILDWG S 7 � � <br />PWM8ING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHAf1GE <br />PU�uC WORKS <br />TOTAL <br />WHEN PROPERLY VAL�DATED <br />FEE <br />� <br />S <br />S <br />RECEIPT NO. <br />� iss�oo <br />IS YOUR PERMIT <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN pl'�i�fti�"�t, ;,'� ,_ �� ��+ << �� <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />