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(heFrcrgn•un ��� r-�qNSTRUCTION � � <br />CIT1 OF <br />everett PERMIT PERM�TNo. _ �:�;���� � <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br />OK'NER MA�la0DRE55 CrtY 2N CMON[ <br />Peter Bjorklund 5114 5. 3rd Ave. Everett, 258-1665 <br />TEN�NT �'�ILnDDRE55 CITY ZIV+ P��ONE <br />AnCNII[GTORpESIGNER MAILAD�PE55 CITY ZIP PHONE <br />GENERALCONTRACTCP MAILApOAE55 CITY ZIP PMONE LICENSE� <br />niECHANICAICONTRAGTOR MAILADDRE55 CITv ZIP PMONE LiCENSE� <br />Valley Nat. Gas 2605 AfcDougall, Everett, 98201 259-5492 VALLENG153L1 <br />PIUMBING CONTRnCTOR M�IL PDDBE55 CITY 21P PHONE UCENSE • <br />C1A550F WOBN <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />- ^-^ ^' ^^^ I CONTACT PF.RSON AND P��ONE NO IF OTM[R T�i�rv nuuvt <br />:ESCRI�E WORK ANO $OUARE LOOTAGE INVOLVED <br />Install furnace and water tank <br />PPOPOSED USE OF BUILDING <br />SFR <br />LEC4L OESCRIPTION OF PROPERTY ISIIOW DELO\V OR AiTACM fOUR COPIES� �� <br />LOT _ OIOCK — OP �I <br />J013AOORE55 <br />5114 S. 3rd Ave. <br />PLUMBINu <br />NO. TYPE OF FI%TURE <br />KITCHEN SINK S DISP. <br />DISHWASHER <br />LAUNDRYTflAY <br />CLOLHESWASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />OACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — DAF, Ei'C.� <br />USE ZONE <br />ivic orcoxsrnuCuon nuoxaeie <br />StZE 0� OL�G <br />OCGl1PANCY LOAD <br />R6ASON FOR 5�'RINKL[RS <br />APPLICATIONACC GY <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />RE�RSETOACN <br />�rq AR[A <br />nciuct <br />NO OF STORiES <br />RPE SVRiNNLERS RE00 <br />] YES ❑ NO <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A�C - n'HNDLG UNRS - H P <br />1 FORCED AIR SVSTEMS - � T.U. M EA <br />UNIT HEATERS - � T.U. � 7 <br />CLOTHLSDRVEFS <br />VENTILATION FAN <br />RANGEMOOD <br />1 WATER MEATER '+ o <br />K'000 STOVE <br />METAL FlREPLACE 8 CHIM �'�L <br />FIR[PLACE INSERT <br />I1EAT PUMP F; 9 <br />Z GA$ PIPING <br />E%MAUSTFAN <br />CNECK NU610ER <br />SUBTOTAL <br />PEHMIT <br />TOTALFEE <br />FEE <br />VACANT SITE — <br />FEES <br />❑ YES ❑ NO <br />�po��' Ho oro�yEumcuvrs BUILDiNG S <br />PLUAIDING <br />DASE��ENT <br />❑ VES ❑ NO MECHANICAL <br />��EIGMTLIM.RAiIOrv OtHER <br />STATC- �UILDING SURCHARGE <br />STA�EENERGVSURCNARGE <br />CITY OF EVERETT pUOLIC WORKS <br />LOCALSALES <br />TAX CODE IS TOTAL <br />3105 ....._..........�.......... <br />FEE <br />� <br />S <br />5 <br />RECEIPT N0. <br />IS IS VOUR <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN qDDRESS f I�[ �� �1; ` I _. <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />