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'h°h'''rWren" _ C`)NSTRUCTION <br />clry or everett PERMIT PERMIT NO. ?5145 <br />259-8810 <br />❑ DEMOLITION 0 COMBINATION 21 BUII DING 0 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEn MAIL ADDRESS cill ZIP ••'•I <br />Jerry MGM 6 Beata Wainscott 1301 63rd St. Everett 347-5908 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE LICENSE. <br />Valley Nat. Gas <br />2605 McDougall Everett <br />98201 <br />259-5492 <br />PLUMBING CONTRACTOR <br />MAII ADDRESS <br />CITY <br />ZIP W'ONE LICENSE. <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTERATION 0 REPAIR ❑ DEMOLITION G BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO IF OTHER THAN AUUVt <br />CONTRACT PRICE OF WORK: $ <br />DESCRIBE WORK AND SOUARE FOOTA <br />444.A0 <br />C.B and later heater <br />I <br />PROPOSED USE OF BUILDING 07/18/90 3:21PM OM#2691 4:: tt <br />Sm / <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH TOM COPIES) 000025145 <br />LOT — BLOCK _ OF TECH $30.00 <br />CHECK $30.00 <br />.JOB ADDRESS <br />1ZF11 w4mi Rf•_ <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A C — A HNDLO UNITS — H P <br />BATHTUB <br />FORCED AIR SYSTEMS — BTU. MEA. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS — B T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP, <br />VENTILATION FAN <br />DISHWASHER <br />RANGEMOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE S CHIMNEY <br />DRINKING FOUNTAIN <br />ri <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS — RAINLEADERS <br />EXHAUS I FAN <br />SINK (SERVICE — BAR. ETC) <br />—100 Version Burner <br />SUBTOTAL <br />f <br />SUBTOTAL <br />f <br />PERMIT <br />f <br />PERMIT <br />f <br />lb <br />UU <br />TOTALFEE <br />$ <br />TOTALFEE <br />f <br />FRONT SETBACK <br />REAR SETBACK <br />.10L SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />BUILDING CODE <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYTEOFCONSTRUCTINCLDNARE <br />TIFF OF CONSTRUCTO ACTUAI <br />UNITS <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />30 <br />00 <br />OCCUPANCY LOAD FIRE SPRINKLERS REDD <br />❑ YES ❑ NO <br />REASON FOR SPRINKLERS <br />HEIGHTLIMITATION <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 />WHEN PROPERLY VALIDATED <br />THIS IS <br />YOUR PERMIT <br />PERMITS EXPIRE IF WORK IS NOT COMMENTED WITHIN ADDRESS FILE 25145 <br />180 DAYS OR CEASES FOR MORE THAN 180 L'nYS. <br />