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CITY OF EVERE17 <br />"'ONSTRUCTION <br />*259-8810 PERMIT PERMIT NO. 27385 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING BXMECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILADDRESS CITY ZIP PHONE <br />Doug Fordham 3509 - 7th Ave SE - ;#B Everett 98204 355-1875 <br />TENANT <br />MAIL ADDRESS <br />MAILADDRESS <br />CITY ZIP PHONE <br />CITY ZIP PHONE <br />GENERAL CONTRACTOR MAILADDRESS CITY ZIP PHONE LICENSER <br />MECHANICAL CONTRACTOR MAILADDRESS CITY ZIP PHONE LICENSER <br />Valley Natural Gas Inc 2605 Mcmugall Everett 98201 259-5492 VALLENG153L1 _ <br />PLUMDINO CONTRACTOR MAILADDRESS CITY ZIP PHONE LICENSER <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION UALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />CONTACT PERSON AND PHONE N0. IF OTI IER THAN ABOVE <br />CONTRACT PRICE OF WORK: $ 450.00 <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />Install gas ➢igwailheater _ �'t=�i -,n_Qc r,,4201- I i <br />PROPOSED USE OF BUILDING <br />HECH155.00 <br />Single family residence , <br />rasa^ 7 •a7 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) HECH :45.00 <br />LOT_ BLOCK <br />TECH $30.00 <br />JOBADDFESS <br />9509 - 7th Ave SE - 6B <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 />AC-A+INDLG UNITS - H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />LAVA,'ORY(WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />KRONER <br />CLOES <br />KITCHEN SINK 8 DISP. <br />VENTILATION FAN <br />VENTHATIONF N <br />- <br />DISHWASHER <br />_ <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />_ <br />ROOF DRAINS - RAINLEADERS <br />EXHAUS- FAN <br />SINK(SERVICE - BAR, ETC.) <br />I <br />IWAI I hpAtpr- iONiRTR <br />SUBTOTAL <br />S <br />SUBTOTAL <br />S <br />I <br />no <br />PERMIT <br />S <br />PERMIT <br />S <br />TOTAL FEE <br />S <br />TOTALFEE <br />S <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />F.ECFIPT NO. <br />USEZONE <br />LOTAREA <br />VACANT SITE <br />❑ vEG ❑ No <br />FEES <br />BUILDING CODE <br />VALUATION <br />FEE <br />BUILDING <br />5 <br />TYPE OF WNSTPUCTION ALLOWABLE <br />TYPE OF CONSTRUCTION <br />ACTUAL <br />aAaurR <br />NO.OFOWEWNGUNITS <br />PLUMBING <br />SIZE OF BLDG. <br />NO. OF STORIES <br />BASEMENT <br />❑ YES ONO <br />MECHANICAL <br />30 <br />00 <br />OCCUPANCY LOAD FIRE SPRINKLERS REOD HEIGHT LIMITATION <br />❑ YES ❑ NO <br />REASON FOR SPRINKLERS <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS <br />3105 <br />PUBLIC WORKS <br />TOTAL <br />30 <br />00 <br />uni.-w, nnnnrm v vw. <br />�n wrrn ru,n <br />�o vn� �n nrnwur <br />w <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN 27385 <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. ;?RFSS FILE <br />