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Me CITYOfT'` 1 L ONSTRUCTION <br />Everett PERMIT PERMIT NO. 25741 <br />259-8810 <br />❑ DEMOLITION <br />❑ COMBINATION ❑ BUILDING <br />❑ MECHANICAL <br />❑ PLUMBING ❑ SIGN <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />CISNER <br />Billie Dady <br />5302 S 3rd Ave Everett, WA <br />259-2444 <br />TENANT <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />MAIL ADDRESS CITY ZIP PHONE LICENSE <br />GENERAL CONTRACTOR • <br />Valley Natural Gas 2605 McDougall Ave 259-5492 VALLENG153LI <br />MECHANICAL COMPACTOR <br />MAIL ADDRESS CITY )IP PHONE LICENSE <br />MAIL ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION XF. ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO. IF OTHER THAN ABOVE <br />CONTRACT PRICE OF WORK $ 634 <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />Install circ. heater and HIRT <br />PROPOSED USE OF LOWING <br />Single family residence <br />LEGAL DESCRIPTION OF PROPERTY )SHOW BELOW OR ATTACN FOUR COPIES) <br />LOT - BLOCK - OF <br />ADDRESS A <br />PLUMBING <br />MECHANICAL <br />FEE <br />N0. <br />TYPE EQUIPMENT <br />FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />UNITS - H.P <br />A/C IT <br />WATER CLOSET (TOILET) <br />FORCED AIR SYSTEMS-BT.U. MEA. <br />C D AIRA/HNSY <br />BATHTUB <br />UNIT HEATERS -B.T.U. M <br />LAVATORY (WASH BASIN) <br />CLOTHES DRYERS <br />SHOWER <br />VENTILATION FAN <br />KITCHEN SINK 8 DISP. <br />RANGE HOOD <br />DISHWASHER <br />1 <br />WATER HEATER <br />LAUNDRYTRAY <br />WOOD STOVE <br />CLOTHES WASHER <br />METAL FIREPLACE 8 CHIMNEY <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />2 <br />GAS PIPING <br />BACKFLOW PREVENTERS <br />ROOF DRAINS - RAINLEADERS <br />EXHAUST FAN <br />1 <br />5M BTU Circulation heater <br />SINK(SERVICE - BAR. ETC.) <br />SUB TOTAL f <br />30 <br />00 <br />SUB TOTAL f <br />S <br />15. 00 <br />N <br />PERMIT S <br />PERMIT <br />S <br />OO <br />TOTAL FEE <br />f <br />TOTAL FEE $ <br />FRONT SETBACK <br />REAR SETBACK SIDE <br />SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />BUILDINOCODE <br />FEE <br />❑ YES ❑ NO <br />BUILDING <br />$ <br />TYPE OF CONSTRUCTION ALLOWABLE <br />TYPE OF CONSTRUCTION ACTUAL <br />"� <br />NO OF DWELLING UNITS <br />PLUMBING <br />SIZE OF BLDG. <br />NO. OF STORI ES <br />BASEMENT <br />45 <br />0 <br />❑ YES ❑ NO <br />MECHANICAL <br />OCCUPANCYLOAD FIRE SPRINKLERS REO'D HEIGHT LIMITATION <br />OTHER <br />❑ YES ❑ NO <br />STATE BUILDING SURCHARGE <br />REASON FOR SPRINKLERS <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />PUBLIC WORKS <br />TOTAL <br />45 <br />00 <br />TAX CODE IS <br />M.M. <br />31-- <br />WHEN PROPERLY VALIDATED <br />TFAS IS <br />YOUR PERMIT <br />37k, <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDRESS FILE 25741 <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />