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fhP EPK'FAR'PF•n C INSTRUCTION <br /> 'r C C C <br /> everett PERMIT PERMIT NO. 2-5065 <br /> 259 -8810 SIGN <br /> 0 DEMOLITION 0 COMBINATION ti BUILDING 0 MECHANICAL 0 PLUMBING <br /> 114,NE11 MAIL ADDRESS CITY ZIP ' <br /> Zwaschka, B. 5808 219th SW Mountlake 'Terrace, WA 98043 778-7995 - <br /> MAIL AOIIRF S[ CITY DP NgNL <br /> TENAN <br /> ARCNRECT KNI OFSIONEP <br /> MAIL ADDRESS CITY ZIP PHONE <br /> CITY ZIP PHONE LICENSE R <br /> GENERAL CONTRACTOR <br /> MAIL ADDRESS <br /> OwneI <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CRY ZIP MN)NE LICENSE <br /> PLUMBING CONTRACTOR <br /> MAIL ADDRESS CITY ZIP PHONE LICENSER <br /> H n H <br /> It CLASS OF WORK <br /> a q ❑ NEW ❑ADDITION ❑ ALTERATION Dt REPAIR [I DEMOLITION [I BUILDING RELOCATION <br /> A <br /> 01 CONTACT PERSON AND M40NE NO IF OTHER THAN ABOVE <br /> CONTRACT PRICE OF WORK S 4,800 Bruce ZWaeChkB 778-7998 <br /> H a .•?r. <br /> 71 SCRIBE WORK ANDSCUARE FOOTAGE MVO(VCD <br /> HyC z n Replace roof of Gunit apt. <br /> H <br /> Oxo0 <br /> 'AIH 'T1 <br /> CA H <br /> o 5 I'll USE OF III DING <br /> 24 SquA.rea 28' x BO' <br /> y 17 ,LGAL DESCRIPTION OF PROPERTY(SHOW RELOW OR AIT ACH IOUR CONES' <br /> OH HIy-y-I <br /> U -T BLOCK O` - <br /> t T3 <br /> t x <br /> 111...yyyH y ___ <br /> C.) tqq y 323 - 76th St. BE <br /> hT C PLUMBING MECHANICAL <br /> I'AfTYPE OF EQUIPMENT FEE <br /> Z y N N0. TYPE OF FIXTURE OR ITEM FEE N0. <br /> T-3 OLO A'C-A,HNDLG UNITS-HP <br /> WATER CLOSET(TOILET) <br /> BATHTUB FORCED AIR SYSTEMS-BTU MEA <br /> LAVATORY(WASH BASIN) UNIT HEATERS-B T U M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK A DISP. VENTILATION FAN u ` <br /> DISHWASHER RANGE HOOD <br /> LWATER HEATER <br /> AUNDRYTRAY ` <br /> WOOD STOVE <br /> CLOTHES WASHER <br /> URINAL <br /> METAL FIREPLACE 8 CHIM <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> HEAT PUMP <br /> FLOOR DRAIN <br /> BACKFLOW PREVENTERS _ GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINN(SERVICE-BAR.ETC) <br /> SUBTOTAL <br /> BUB TOTAL t f <br /> IT f PERMIT <br /> PERMf <br /> TOTALFEE f TOTAL FEE f <br /> !1= I I,vA SETBACK REMISETBACK S-DE SETBACK PLAN CHECK NUMBER FEE RECEIPT NO <br /> USE ZONE LOT AREA VACANTSRF FEES euamNG cooE FEE <br /> ❑YES U BUILDING NO VALUATION 72 00 <br /> TYRBICMSIR IKAMLBLVIIRII HIT N CBNSTWMR ACTIMI "`` NO UBWFIIMC UMiS S <br /> PLUMBING <br /> SIZE OF BLDG NO OF STORIES BASEMENT <br /> O YES 0 NO MECHANICAL <br /> M OCCUPANCY LOAD F IRE Sf'RMKlERS BEOD HEIGHT LIMITATION OTHER <br /> 0 YES O NO 4 50 <br /> STATE BUILDING SURCHARGE <br /> REASON FOR SPRINKans <br /> STATE ENERGY SURCHARGE <br /> APPLICATION ACC BY %ANRAP MI:0BY CITY OF EVERETT <br /> LOCAL SALES PUBLIC WORKS <br /> TAX CODE IS TOTAL 76 50 <br /> 3105 WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT <br /> PERMITS EXPIRE IF WORK 15 NOT COMMENCED WITHIN ADDRESS PILE L b 0 65 <br />