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`��'��� "y�` �JNSTRUCTION �-� '�" <br /> everett PERMIT PERMITNO. 2309 { <br /> 259 -8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �I MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEF MMLAODRE55 CITY ZIP PHONE <br /> Ji.m Benthu;sen 5117 23rd Ave. W. Everett 96203 398-6187 <br /> TENANT A,1qILA0DRESS CITY ZIP PHONE <br /> ARCHRECT OR 7ESIGNER MAIL AD�FESS CITV ZIP PhANE <br /> GENERALWNTRACTOR MAILADDRESS CITY 21P PHONE LICENSEM <br /> MECHANICALCONTRACTOR MAI�ADDRESS CITV ZIP PHONE UCENSE• <br /> Valley Nat Gas 2605 McDougal Everett 98201 259-5492 VALLENG153LI <br /> PLUMBINGCONn�pCTOR MAILPOOFE55 CITY 21P PHONE LICENSE• <br /> CIASS OF WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> COYTACT PERSON AND PMONE NO.IF OTHER TMAN ABOVE <br /> CONTRACT PRICE OF WORK:$ <br /> �DESCHIBE WOHK nND SOUARE FOOTAGE INVOLVEO <br /> Install gas furnace <br /> PROPOSEO USE OF BUILLtING <br /> SFR <br /> LEAAL DESCRIPTION OF PROPEFTY�SHOW BELOW OR ATTACN FOUR COPIES� <br /> LOT_ BLOCK_OF <br /> JOB A�DHESS <br /> 5117 23rd Ave. W. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMEN7 FEE <br /> WATEfl CLOSET(TOILET) A/C-�A/HNOLG UNITS-H.P. <br /> BATHTUB FORCED AIR SYS7EMS-B.T.U. M EA. <br /> LAVATORVIWASHBASINI UNITHEATERS-B.T.U. � +� �,cn , c1 � ..•,�..y. <br /> SHOWER CLOTHES�RYERS - <br /> KITCHEN SINK 8 DISA. VENTILATION FAN , .�� � <br /> DISHWASHER RANGE HOOD <br /> � <br /> LAUNDRVTRAV WA7EP HEATER <br /> � <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> ORINKING FOUNTAIN FIREPLACFINEERT <br /> FLOOR DRAIN HEATPUM? <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHA�J57 FAN <br /> SINK(SERVICE-BAR,ETC.) <br /> SUBTOTAI S SUBTOTAL S 9 O <br /> PEHMI7 S PERMIT f 1S O <br /> TOTAIFEE S TOTALFEE S 24 O <br /> FRONT$ETBACK REAR SETBr1CN SIDE SETBACK P�P,N f.HECN NUMBER FEE RECEIPT NO. <br /> USEZONE LOTAREA VACANTSITE <br /> ❑ YES O NO <br /> FEES BUILDING CODE FEE <br /> iYPEOFCONSTF(ICiIONALLOWaBtE 7VPEOFCONS7PlICTIONAGTUAI °�qo�'„'°`' NO.OFOWELLINGUNIIS BUILDING �S <br /> PLUMBING <br /> 512E OF BL�G NO OF STORIES BASEMENT <br /> ❑VES ❑ NO MECIiANICAL 24 00 <br /> OCCUPANCVLOAD FIRESPRINKLERSREO'D HEIGMTLIMITATION OTHER <br /> ❑ VES ❑ NO <br /> REASON iOR SPRINKLEflS STATE BUI LDING SURCHARGE <br /> STATEENERGVSURCHARGE <br /> APPLICATIONACC.BV PLANSAPPqOVEOBY CITY OF EVERETT <br /> LOCAL SALES PUBLIC WORKS <br /> TAX CODE IS 707AL z4 00 <br /> S.H. 3105 <br /> WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT <br /> PERMITS EXPIRE IF WORK iS NOT COMMENGED WITHIN ADDRESS FILE � 3 � <br /> 180 DAYS OR CEASES FOR MORE THAN 180 DAYS. �' � � <br />