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"�E°�'�'�" `�`` CF�VSTRUCTI ON --- � <br />CITY OF <br />everett PERMIT PERM�TNo. ���4� <br />259-8810 <br />❑ DEMOLITION IJ COMBINATION ❑ BUILDING �] MECHANICAL f� PLUMBING O SIGN <br />OWNER MAILAp�RESS dTY ZIP PNONE <br />Dorothy Mascio 1024 35th Street Ever.ett 252••7392 <br />TENANT MA:LApDRESc LITY ZIP PHONE <br />MAILAOORESS pTY ZIP PMONE <br />GENERALCONTliACTOR 61/.�LADDRE55 CITY ZIP PNONE LIGENSE� <br />MECHANICRLCONTRALTOR MAI�A�DRE55 CItY ZIP PNONE UCENSE✓ <br />Valley Natural Gas 2605 tdcDouqall Everett 259-5492 VALLENG153L1 <br />?WMBWGCONTRACTOP MAILAO�flE55 CITY ZIP PHONE UCENSEz <br />CLASS OF WORK <br />O NEW O ADDITION }f] ALTEHATION ❑ REPAIR C DEMOLITION ❑ BUILpIiiG RELOCATION <br />CONTACT PEPSON AND PMONE N0. IF OTMER THAN ApOVE <br />CONTRACT PRICE OF WORK: S Z518 _ 00 <br />OESGRIBE WOPN ANO SOUAFE FOOTAGE INVJLVED <br />Install furnace and water heater <br />SFR <br />LEGAL DESCF�FTipN OF VROPERTY (SMOW BELOW OR ATTACH FOUF COP�ES� 04/�^c/91 11:43AM OOQAH6590 �kt::t:�K <br />LOT - BLOCK - OF � <br />41000�6805 <br />NEEI i <br />H00026806 <br />iufEEl I—t—�f "-� w— <br />J00 AOORESS t1OOOLOBO 1 <br />PLUMBING <br />TVPE OF FI%TURE <br />WATER CLOSET (TOILET) <br />BATMTUB <br />SHOWER <br />KITCHEN SINK 8 <br />LAUNDRYTflAY <br />CLOTNES WASHER <br />URINAL <br />�RINKING FOUNTAIN <br />FLOOR DRAIN <br />EACKFLOW PREVENTERS <br />flOOF DRAINS — RAIMLEADERS <br />SINK (SERVICE — BAR, ETG) <br />FRONTSETBNCK <br />USEZONE <br />ttPE OF CGNSiPUC(ION FLlOWABLE <br />SIZE OF pLOG <br />OCCUPANCYLO�D <br />REASON FOR SPRINKL[RS <br />AFPLICATION ACC. �Y <br />MECHANICAL p01 <br />fEE NO. TVPE OF E� � <br />A/C — A/HN�LG UNITS — H�� <br />FORCED AIR SYSTEMS — B.�el <br />11NITHEATERS—B.T.U. C{j'�, <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />META� FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUbTOTAI 5 <br />PEHMIT 3 <br />TOTALFEE 5 <br />\R SETpALK SIpE SET�ACK <br />LOT FR@A <br />IVf4 OP CONSiflUCiION ACiOAI <br />NO OF STORIE.�i <br />FIBE SPRINKLERS qE0'D <br />❑ YES ❑ NO <br />FNS APPROVEO BY <br />PLAN CHECK NUMBER <br />SUBTOTAL <br />PEflMIT <br />TOTALFEE <br />FEE <br />V�CRNT SITE FEES <br />❑ VES ❑ NO <br />°`�6i�auriOY NOOF�WELLI9GUNi75 BUILDING S <br />PLUMBING <br />onser.+eNr <br />❑ VES ❑ NO h1ECHANICAL <br />HEIGHTUMITATION QTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />CITY OF EVERETT pUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS TOTAL <br />3105 WHEN PROPERLY VALI <br />PERMITS EXPIRE IF WORK IS NOT COMMENI:ED WITHIN <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />ADORESS FILE <br />M EA. <br />M d <br />FEE <br />�5 <br />RECEIPT NO. <br />FEE <br />THIS IS YOUR <br />65 00 <br />MIT/ <br />V <br />268�� <br />