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_ CITY OF EVERETT <br /> �ONSTRUCTION �� <br /> PERMIT PERMITNO. 27679 <br /> 259-8810 <br /> �] pEMOLRION ❑COMBINATION ❑ BUILDING ❑MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ��ryEq MAI�hODRESS CRV ZIP PHJNE <br /> R A Johnaon 1902 19th Ave SE Everett 98208 337-4830 <br /> TENM7T Mr11LADGPE55 CITY ZIP PHONE <br />, �RGNRECTOROESIGNER MAILADDFE55 CT' 21P F'HONE <br /> GENERALCONTRACTOF MAILAD�RE55 CITV ZIF PHONE LICENSE� <br /> Gaffney Construction 1715 100tti P1 SE Everett 98208 338-2114 GAFFNCI104K3 <br /> MECHMIIC�LCONTRACTOR MA�IADDREaS CITY ZIP PHONE LICcNSE� <br />� PLUMBINCaWMRACTOP M4ILADDRE55 CITY ZIP PHONE LICENSEII <br /> CUSS OF WORK <br /> ❑ NEW ❑ ADDIf10N ❑ ALTERATION ❑ REPAIR � DEMOLRION ❑ BUILWNG RELOCAl10N <br /> C(1NTACT PERSON ANO PHONE NO.IF OTHER TNAN ABOVE <br /> CONTRACT PRICE OF WORK• $ <br /> DESCRIBE WORKAND SOU�RE FOOTAGE INVOLVED <br /> Demolish single family residence <br /> PROPOSED USE OF BUILDIHG <br /> LEOAL DESGRIPTION OF PRJPERTY(SHOW BELOW OR ATTACM FOUR COPIES) �'� <br /> LOT�BLOCK_OF ,_, .. �C <br /> � <br /> L <br /> E SRCH �4.50 <br /> BADDR S � � <br /> •3�Y19th Ave SE <br /> PLUMBING MECHANICAL <br /> � N0. TVPE OF FlXTURE OR REM PEE NO. TYPE OF EOUIPMENT FEE . . , _.:,_�� <br /> WATERCLOSET(TOILE'f) A/C—NFINOLGUNITS—H.R � � <br /> � � �� �� BATHTUB FORCEDAIRSYSTEMS—B.T.U. MEA. <br /> r UVATORY(WASHBASIN) UNITHEATERS—B.T.U. M <br /> ' � SHO'NER CLOTHES ORYERS <br /> �� � KITCHEN SINK 8 OISP. VEMILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY 4JATERHEATER <br /> CLOTHES WASHER WOOD STOVE � <br /> URINAL METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FWNTAIN FIREPLACE INSERT �' <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK iSERVICE—BAR,ETC.) <br /> SUBTOTAL S SUBTOTAL f � <br /> PERMR S PEqMR t <br /> TOTALFEE S TOTALFEE i <br /> FRONTSETBPCN REARSETBACK SIDESETBACK p�ANCHECKNUMBER FEE RECEIPTNO. <br /> USEZONE LOTAREA VACANTSITE FEES BU����CNOE FEE <br /> ❑YES ❑NO <br /> TYPEOFGONSTIIUCTIONALLOWABLE T"PEDFCONSTFOCTIONr1CIDAL �yapr ���ELLINGUNITS BUILDINCa S <br /> PLUMBING <br /> SIZE OF BLOG. N0.OF STORIES 9ASEMENT <br /> ❑vEs ❑rv0 MECHANICAL <br /> OCCUPANGYLOAD FIRESPRINKLERSREO'D HEIGNTLIMITAT!ON QTHER <br /> ❑YES ❑NO (+ O <br /> REASON FOR SPPIN�cLERS STATE BUILDING Sl1RCHARGE <br /> STATEENERGYSURCHARGE /�� <br /> APPLIC,ITIONRCC.BY PUNSAPPROVEDBV CITYOFEVERETT / <br /> LOCAL SALES PUBLIC WOfiKS <br /> TF+X CODE IS 7pTAL <br /> 3105 <br /> WHEN PROPERLY VALIDATED THIS IS YOUR PERMR <br /> PERMITS EXPIRE IF iNORK IS NOT COMMENCED WITHIN `��6 7� <br /> 180 DAYS OR CEASES FOR MORE THAN 180 DAYS. ADDRESS FILE <br />