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CITY OF EVERETT A� <br />CONSTRUCTIONS <br />PERMIT PERMIT NO. 27615 <br />*259-8810 <br />❑ SIGN <br />❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ MECHANICAL ZIP ElPLUMBING,oNE <br />OWNER MAILADDRESS <br />.Tamnc A. Waalc 2110 63rd St SE Everett 98203 353-3093 <br />Tp PHONE <br />on <br />RACTOR <br />Nat Gas 2605 <br />' CLASS OF WWm <br />n urw ❑ ADDITION <br />CONTRACT PRICE OF WORK: 11565. 00 <br />DESCRIBE WORK AND SQUARE FOOTAGE IIIVOLVED <br />Install furnace & HWIJ <br />i <br />PROPOSED USE OF BUILDING <br />SFR <br />I LEGAL DESCRIPTION OF PROPERTY ISIIOW BELOW OR <br />LOT BLOCK -OF_ <br />MAIL <br />MAILADDRESS <br />CITY ZIP <br />MAILADDRESS <br />CITY ZIP PHONE LICENSE E <br />MAILADDRESS CITY ZIP NSE0 <br />PHONE LK:E <br />ougall Ave 259-5492 Everett 98201 ZIVALLENG15PLo1E LICENSEE <br />MAILADDRESS CITY <br />❑ ALTERATION ❑ REPAIR ❑ DEMOLITION O BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO IF OTHER THAN ABOVE <br />nrEn <br />#00027616 <br />MECH $75.00 <br />DBAODFIESS <br />3E <br />CHEp' $1z0 00 <br />2110 63rd St <br />MECHANICAL <br />PLUMBING <br />NO. TYPE OF EQUIPMENT FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />A/C - AMNDLG UNITS - H.P <br />WATER CLOSET (TOILET) <br />1 FORCEDAIR SYSTEMS-B.T.U. MEA <br />BATHTUB <br />UNIT HEATERS-B.T.U. M <br />LAVATORY (WASH BASIN( <br />CLOTHES DRYERS <br />SHOWER <br />VENTILATION FAN <br />KI(CHEN SINK A DISP <br />RANGE HOOD <br />DISHWASHER — <br />1 WATER HEATER <br />LAUNDRY TRAY <br />WOOD STOVE <br />CLOTHES WASHER <br />METAL FIREPLACE 6 CHIMNEY <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />2 GAS PIPING <br />BACKFLOW PREVENTERS <br />EXHAUST FAN <br />ROOF DRAINS - RAINLEAGERS <br />SINK (SERVICE - BAR, ETC.) <br />SUS TOTAL f 40 <br />00 <br />" SUBTOTAL <br />f <br />PERMITi 15 <br />00 <br />PERMIT_ <br />S <br />TOTAL FEE IS 55 <br />00 <br />�- _--TOTAL <br />= <br />PLAN CHECK NUMBER FEE RECEIPT NO <br />FRONTSETBACK REAR SETBACK <br />SIOL SETBACK <br />LOTAREA <br />VACANT SITE <br />FEES UIL IN DE FEE <br />_ <br />USE ZONE <br />❑ YES ❑ NO <br />$ <br />nPE DF CONSTRUCTION ALLOWABLE TYPE OF CONSTRUCONSTRUCTIONAC1UAl Dc=' ND OF pYEWgVKRS <br />BUILDING <br />PLUMBING <br />SIZE OF BLDO NO. OF STORIES <br />BASEMENT <br />MECHANICAL 55 <br />00 <br />❑ YES ❑ NO <br />OCCUPANCY LOAD FIRE SPRINKLERS AEG <br />HEIAHT LIMITATION <br />OTHER <br />❑ YES ❑ No <br />STATE BUILDING SURCHARGE <br />REASON FOR SPR":KLERS <br />( <br />STATE ENERGY SURCHARGE <br />I APpuCATKNIACC. BY PLANS APPROVED BY <br />CITY OF EVERETT <br />PUBLIC WORKS <br />- <br />LOCAL SALES <br />TAX CODE IS <br />TOTAL 55 <br />00 <br />3105 <br />VALIDATED THIS IS YOUR PERMIT <br />I' <br />WHEN PROPERI.Y <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WI` HIN ADORES FILE <br />ISO DAYS OR CEASES FOR MORE THAN 180 Di ).Mill <br />7u15 <br />