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`�E°��" "`' G'�NSTRUCTIOtV -�� '� <br />CITY OF 7 <br />everett PERMIT PERMITNO. �� +2� <br />259-8810 <br />❑ DEMOLITION �i9 COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER IdAILA0URE55 QTV ZIP PHONE <br />Karol J. Terrio I'.0. Box 259 Lake Stevens, WA 98258 237-5398 <br />TENFNT hIAILADORESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADORESS CITY 2tP FNONE <br />GENERALCONTRACTOR <br />Owner <br />PLUMBING CONTf14CTOR <br />CLASS JF WORK <br />MAIL ADDfiE55 <br />MFIL ADDRESS <br />MAIL A�DflE55 <br />ciTv <br />CITY <br />CITY <br />❑ REPAIR ❑ DEMOLITION <br />Zip PNONE LICENSE� <br />ZIP PMONE LICENSE • <br />ZIP PNONE LICENSE� <br />❑ BUILDING RELOCATION <br />� I CONTACT PERSON ANO PMONE N0. IF OTHER THFN PIiOVE <br />_ __ __ _ ____.__ __...__., n AS nnn nn <br />E WORH AND SOUNRE FOUTnGE INVOLVEO <br />New Construction <br />PROPOSE� USE OF BUILOING <br />Single family residence <br />LEGAL DESCRIP�ION OF PPOPERTY (SMOW BELOW OR ATTACH FOUR COPIES) <br />,.OT _ BLOCN _ OF — <br />See Attached 3629�4-4-056-0006 <br />528 Slst St. SW <br />PLUMBING <br />NO. TYPE OF FIXTURE <br />2 WATEft CLOSET (TOILET) <br />2 BATHTUB <br />3 LqVATORVIWASH BASIN) <br />1 SHOWER <br />1 KITCHEN SINK 8 DISP. <br />CLOTIIES WASHER <br />URINAL <br />ORINh:ING FOf1NTAIN <br />FLOOF' DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />U!iE ZONE <br />Y.-1 <br />7Yff OF C09SiPUCiION ALI.OR'AI <br />V-N <br />SIZE OF BLDG <br />1244 <br />occuanr�cr ioao <br />N/A <br />REASONFOR SPRINKLERS <br />APPLICATION ACC. BY <br />S.H. <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />REARSETOACN <br />20 <br />LOT AREA <br />75x150 <br />tta� oF cor+sreucnox attua� <br />V=N <br />NQ OF STOPIES <br />IE SPRINNIERS REO'D <br />VES C,�NO <br />J.W. <br />MECHANICAL <br />FEE NO. TV?E OF EUUIPMENT <br />LO O NC—NHNOLGUNITS—H.P. <br />�.O OO FORCEU AIR SVSTEMS — B T.U. M <br />LS DO UNITHEATERS—AT.U. M <br />S O ]. CLOTHESDRYERS <br />S O ]. VENTILATION FAN <br />S O 1 RANGEHOOD <br />1 WATER HEATER <br />S O WOODSTOVE <br />METAL FlREPLACE 8 CHI /gq <br />FIREPLACEINSERT � <br />HEAT PUM1iP HOODOSG <br />GAS PIPING <br />EXHAUSTFAN �OOOG1�� <br />6o bo I I sue <br />S ren n <br />S 60 0 ror , i <br />5!�E SETBaCN PLAN CHECK NUMBER �0�7136 <br />6 89/21723 SEG�F1.80 <br />VACANT,ire FEES oi co[ <br />� YES ❑ NO <br />�c��v�• NaaFoµEuwcur+its BWLDING p. <br />R-3 1 pLUMBING <br />BASEM[NT <br />❑ YES fjZ NO MECHANICAL <br />HEIGMTUMR4TiON OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGVSURCHARGE <br />CITY OF EVERETT pUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS TOTAL <br />3105 WHEN PROPERLY VALIDATED T <br />FEE <br />4 <br />RECEIPT NO. <br />�0017452 <br />24 <br />3 <br />15 <br />2� <br />699 <br />YOUR PERMII <br />' PERMITS EXPIRE IF WORK IS MOT COMMENI:ED WITHIN ADDRESS FILE ; I 1 G � <br />� 180 DAYS OR CEASES FQ i MGQE THAN 180 DAYS. <br />