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H30 H <br />m Cr+f� <br />J rM <br />Q H <br />HZH <br />K n <br />H 0 <br />IO;J H Ili <br />CA H <br />Hx r <br />LTl O <br />H17 <br />O H ��yy <br />H[OL70 <br /><7H C] <br />zHz <br />HH <br />gy H <br />o t7 N <br />p7 <br />ZH[n <br />HOCol <br />rl <br />u <br />l <br />I_e <br />rl <br />u <br />'hD`°C��OF <br />('ONSTRUCTION -- <br />=� <br />everett <br />PERMIT PERMIT NO. _ <br />231 56 <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION f BUILDING ❑ MECHANICAL ❑ PLUMBING <br />❑ SIGN <br />OWNER <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />Wh Dusenberg 3 Lake Bellevue Dr. Bellevue 98005 454-3991 <br />TENANT <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />ARCHITECT OR DEBIGNER <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />Ned Nelson Arch 3 Lake <br />Bellevue Dr Belleuve 98005 455-4g00 <br />GENERAL CONTRACTOR <br />I.IAIL ADDRESS CITY ZIP <br />PHONE <br />LICENSE <br />Roy Breshears 7211 Beverly <br />BlvdEverett 98203 353-6617 RRrcHC*164r.7 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />LICENSE. <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />LICENSE. <br />CLASS OF WORK <br />:p NEW ❑ ADDITION <br />❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO IF OTHER THAN ABOVE <br />CONTRACT PR CE OF WORK S <br />DESCRIBE WORK ANL SQUARE FOJTAGE WVOLVED <br />New Construction <br />PROPOSED USE OF BUILDING <br />REtail <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />LOT — BLOCK-- OF <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO.W-H <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />LG UNITS - H.P.BATHTUBSYSTEMS-B.T.U. <br />MEA.LAVATORY <br />(HASH BASIN) <br />S - B.T.U. MSHOWER <br />YERSKITCHEN <br />SINK & DISP <br />FANDISHWASHER <br />LAUNDRY TRAY <br />WATEI, HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />METAL FIREPLACE & CHIMNEY <br />URINAL <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />13ACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS - RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE - BAR, ETC.) <br />SUBTOTAL S <br />SUB $ <br />PERMIT 5 <br />PERS <br />TOTALFEE $ <br />TOT <br />FRONT SETBACK <br />REAR SETBACK SIDE <br />SETBACK <br />PLAN CHECK NUMBER <br />I o27349 <br />RECEIPT NO. <br />20 <br />12 <br />12 <br />69/21773 <br />SMHR45 43 .00 <br />17485 <br />USEZONE <br />LOTAREA VACANT <br />SITE <br />FEES <br />I O <br />FEE <br />B-1 <br />41,797 <br />9CYES ❑ NO <br />BUILDING <br />TYPE OF CONSTRUCTIONALLOAABLE <br />PIT OF CONSTRUCTION ACTIVL <br />�a'I <br />NO Oi OAELLING UNRS <br />PLUMBING <br />ENDIII $8 .00 <br />V-N <br />V-N <br />B-2 <br />1 U <br />SIZE OF BLDG <br />NO OF STORIES <br />BASEMENT <br />- <br />3528 <br />1 <br />❑ YES IM NO <br />MECHANICAL <br />OCCUPANCY LOAD FIRE SPRINKLERS REO D HEIGHT LIMITATION <br />OTHER <br />WATER $75.00 <br />❑ YES ONO <br />STATE BUILDING SURCHARGE <br />REASON FOR SPRINKLERS <br />STATE ENERGY SURCHARGE <br />PW PC $ <br />B4 <br />APPLICATION ACC. BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />PUBLIC WORKS <br />TOTAL <br />DPT.20 <br />90 503 <br />83 <br />TAX CODE IS <br />N.N. <br />B.E. <br />3105 <br />WHEN PROPERLY VAL <br />UR PERMIT <br />DPT.20 V5126.90 <br />CHECH $19476.00 <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDRESS FILE <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />23156 <br />