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Uic F.ocrAn•rn <br />C�71 OF <br />everett <br />259-8810 <br />❑ DEMOLITION <br /><�:; :C9 <br />Rod Vonthu� <br />T[NANT <br />OR �ESIGNER <br />GENERAL <br />C ��NSTRUCTION ' <br />PERMIT PERMITNO.. �42 �C <br />❑ COMBINATION ❑ BUILDING x�'i MECHANICAL <br />AIAIL A�OPE55 GTY <br />9600 So. 4th Ave Everett 98203 <br />MAIL ADDRE55 CITY <br />htAiL ADDRESS ���� <br />MAIt AD�RE55 CITV <br />hNR A�DRESS CITY <br />ECNANICALCONTRACTOR <br />N.W. Water Heater 3110 Hill Ave Everett 98201 <br />MAIL AODRC55 GTY <br />URI�ING CONTRACTOR <br />❑ PLUMBING <br />ziv r�+o�e <br />>59-5293 <br />ZiP ���ONE <br />ZIC PMONE <br />ZIP PHONE <br />21P PHONE <br />-5331 NORTEi4 <br />ZIP PHONE <br />❑ SIGN <br />LICENS[ • <br />CLASS OF WORK <br />�Eyy ❑ ADDITION ❑ ALTERATION ❑ REPAIfl ❑ DEMOLITION ❑ BUILDING RELOCATION <br />cor��ncr rc��serv nNo �noNe r+o i�- or��EW n�nr� noove <br />CONTRACTPRICEOFWORK S ZZS OO <br />�ESCRi�E WORK AND SDUARE POOTAGE iNVOLVEO <br />Install as water heater <br />vROPW[D USE OV uURuwo <br />SFR <br />LEGAL OESGPIPiION OF PROPERTV ISMOW 0[LOW OR I.TTACH iOUR CO�ICS� <br />03/^c8/90 9:�6RH OOORN0711 k"1.:4l: <br />�o* _— o�ocK — oF � <br />fl00024�31 <br />HECN 255.0� <br />NOOQ�4�30 — <br />kFr.N s2i.so <br />�O�R�DRE55 <br />4600 So. 4th Ave <br />PLUMBING <br />NO. TVPE OF FIl(TURE OR <br />WAiER CLOSET �TOILET) <br />DATHTUD <br />LAVAIORY�WASH �ASIN� <br />SHOWEH <br />KITCNEN; INR d JISP. <br />DISHWASHER <br />LAUN�RVTRAV <br />CLOiH[S WAS4ER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOF DRAIN <br />BACHFIO�YPREVENTERS <br />ROOF ORAINS - RAINLEAOEflS <br />SINK (SEFVICE - BAR, ETC.) <br />SJBTOTAL <br />PERMIT <br />TOTALFEE <br />FROYTSETD�GN REARSETpACH <br />usezor+e io.tinen <br />i1ROFCON5WUf110NRIlVR�OIF ,tt{EOFCONSfPUCI <br />92c OF <br />ftEA50N <br />BY <br />AC10Al <br />NO OFSTORIES <br />FlPE SPFINKLERS REO�D <br />❑ VES ❑ NO <br />f <br />S <br />S <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPI <br />MC - �� MNDLG UNITS - HP. <br />GOFCED Alii SYSTEMS - B.T.U. <br />UNIT MEATERS - OSL. <br />CLOTMES OIiVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WnTER NEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />C%HAUSTFAN <br />NUMBGR <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />'i FEe <br />vncr.Nr sire FEES <br />❑ VES ❑ NO <br />*'���w�" NOaFOWuuxra�uii5 DUILDING 5 <br />PLUM�ING <br />9n5EMENT <br />❑ VES ❑ NO MECHANICAL <br />HEIGHTLIMITATION OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />CITY OF EVERETT pUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS TOTAL <br />3105 ,.,,,�., ...�.,oeoi v vni i <br />M EA <br />M <br />FEE <br />� <br />5 <br />S <br />RECEIPT NO. <br />IS YOUR <br />21 � 50 <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED W17HIN 1 j`1 )" � <br />no�F;t ss � a�: G�� c, �!�.. <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />�i I so <br />