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Ihr1:i•rr7,r�rn C NSTRUCTION � <br />i!11� Of <br />everett PERMIT PERMITNO. ��2190 <br />259-8810 <br />C' OEMOIITION ❑ COMBINATION ❑ BUILDING IS� MECHANICAL ❑ PLUMBING ❑ SIGN <br />,,��q�q 6�w nnont55 Grr Z�P rHONE <br />Delores Heller 4414 Seahurst Ave Everett, Wn 98203 252-3095 <br />��Hqryi MAIIAODRESS l;ilY 11P PNONE <br />��LNIIECT OR DESIGNER MRIL �ODBLSS CIIY 21P PHDN[ <br />GCNCRAICONiqCC1AR I ti��ILnDDN[5.` CiIY ZIP PMON[ ULENSEt <br />r�ec�u�,iccl�Pa. ro�dh.rn.f �, b S ZE P(ZS s�g��Z/'P cIr�VP/1�7� ��� vHONe LiCENSE� <br />s u <br />�-�NuaLGa�_EQuip 162��._S7aiine_Viuw-Dr--Everett--98301---�5812s4i—NkTURGE934N6- <br />i'WM01YGf.ONLR4CTOR MRILROORC55 CIiV IIP PMDNE LICENSE• <br />Cuss or wnqa <br />❑ "lEW ❑ R�DITION ❑ ALTERATIJt1 <br />CONTRACT PRICE OF WORK: $ <br />oEscaw� woaR �r�o sou•ne r oouec n+voiveo <br />Conversion burner and water heater <br />PROPoSED lJSE O� ONIpING <br />Single family residence <br />LEG4I]lSCRIPTION[NP110�'FRTYISNOW9[LUWORRTT', OURCOPiL`:1 <br />LOT _ (1lOCK - Of <br />IP:q <br />PLUMSING <br />NIT[:NEN $INK 6 DISP. <br />01:,�'W�SNER <br />UUNORY TRAY <br />CLOTHES W nSHEF <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR �RAIN <br />B�CNPLOW PREVENTE <br />ROOF ORAINS — RAINI <br />SINN ISERVICE — BAH, <br />(PONi$ETBRCY. <br />USE20N[ <br />tYPC OF CON5IG.UC�� <br />size oF o�oc <br />OC(:LIVRNCY LO� <br />nEnsON rOn 5�i <br />td. I4. <br />SUBTOTAL <br />PERMIT _ <br />TOT�LFEE <br />e� <br />RFAP SE?BACK <br />LOT PNCA <br />IVPE 0/ GONSiPUCPON PLNI <br />NO OfSTORiES <br />fiRE SPRINnLER5RE0'D <br />❑ YES ❑ NO <br />f3Y <br />❑ REPAIR ❑ DEMOLITION ❑ BUILOING RELOCATION <br />CONi4CT PCRSON ANp P��ONE NO If OTNER T11AN RPOVE <br />MECF'4NICAL <br />FEE NO. TYPEOFEOUIVMENT <br />NC — AMN�LG UNI15 — NP <br />FOPCEOAIRSvSIEMS—BT.U. MEA. <br />UNITHEAiERS—BTU. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />qANGCHOOD <br />N'ATFR HEATER <br />WOODSiOVE <br />METAL FIREPLACE d CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />x GAS PIPING <br />E%HAUSTFAN <br />f SUBTOTAL <br />f PEflM1T <br />� r TOTALFEE <br />sm[ sFTn+Crc 1�'LAN CHECK NUM7ER FEE <br />VAC�NT SiTE � � �p� <br />FEES <br />❑ YES ❑ NO <br />o-� raaowuur+cuNus BUILDING N000221B4 <br />,.�., �— <br />PLUMBIN(i �� <br />oASEMENi <br />❑ YES ❑ NO ��ECHANICAL MECH <br />GG S <br />HEIGHTLIMITFriJN OTHER <br />nFrN <br />STATE �UILDING SURCHnRGE N����.�1181 <br />� <br />STATECNERGVSURCHARGE �" <br />CITY OF EVERETT P��9LIC WORKS NcCH <br />LOCAL SALES <br />TAX CODE IS T!:iAL � <br />__ 3105 —yyHEN PROFERLY VAL�`EQsjj <br />MECH <br />CRSH <br />PrRMITS EY.PIRE IF WORK IS NqT COMMENCED WITHIN qpUAESS FlL[ <br />180 DAYS OR CEASES FOR MORE THAN 1B0 DAYS. <br />�f <br />RECEIPT NO. <br />S3 .5� 30 <br />n <br />g3 .50 <br />_ _5� _30 <br />i�� IS YOUR PERMII <br />5Z0.50 <br />�?U4.50 <br />���� q;�. <br />Li J � <br />