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the E° CITYOF � C('`'NSTRUCTION <br />CITY Oeverett PERMIT PERMIT NO- 22342 <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY 'IP PHONE <br />John Peterson 5208 33rd Ave. W. Everett 98203 355-7883 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />Valley Natural Gas 2605 McDougal Everett 98201 259-5482 V7LLLENG153LI <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE• <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION QALTERATION ❑ REPAIR ❑ DEMOLITION 0 BUILDING RELOCATION <br />CONTACT PERSON AND PHONE N0. IF OTHER THAN ABOVE <br />CONTRACT PRICE OF WORK: $ <br />DESCRIBE' WORK AND SQUARE FOOTAGE INVOLVED <br />Install pool boiler and kffx hot water heater <br />PROPOSED USE OF BUILDING <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT-- BLOCK- OF <br />JOB ADDRESS <br />57nR lira Ava_ W. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET! <br />A/C — A/HNDLG UNITS — H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK d DISP. <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />2 <br />GAS PIPING urluolbll ?• 1 <br />ROOF DRAINS — RAINLEADERS <br />EXHAUST FAN <br />SINK(SERVICE — BAR, ETC.) <br />2 <br />SUB TOTAL <br />$ <br />SUB TOTAL <br />S <br />=48 <br />PERMIT <br />$ <br />PERMIT <br />5 <br />TOTALFEE <br />$ <br />TOTALFEE <br />$ <br />FRONTSETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />BU:I.OING CODE <br />VALHATION <br />FEE <br />BUILDING <br />j <br />TYPE OF CONSTRUCTION ALLOWABLE <br />TYPE OF CONSTRUCTION ACTUAL <br />�1°a NO AFT DWELLING UAITS <br />PLUMBING <br />SIZE OF BLDG. <br />NO. OF STORIES <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />48 <br />0 <br />OCCUPANCYLOAD FIRE SPRINKLERS RED <br />❑ YES ❑ NO <br />REASON FOR SPRINKLFPS <br />HEIGHTUMITATION <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />S.H. <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS <br />3105 <br />PUBLIC WORKS <br />TOTAL <br />48 <br />0 <br />WUCM nonnrn. V VAI <br />Inwren TLHe IQ <br />VnI Io oeoulT <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />ADDRESS FILE <br />22342 <br />