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the Evergreen mONSTRUCTION <br />everett PERMIT PERMIT NO. 21378 } <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS 0r• vnONE <br />Marjorie Downey 714 88th St. Sr, Everett 347-7191 <br />TENANT MAIL ADDRESS GTv ZIP "I NE <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL AOORFS.S CITY DP PHONE LICENSE F <br />MECHANICAL CONLRACTOR MAIL AOMESS CITY ZIP PHONE LICENSE <br />Valley Nat. Gas 2605 McDougall i Everett, 98201 259-9452 VALLENG153L1 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑ NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOUTtON ❑ BUILDING RELOCATION <br />PERSON ANTI MONIL NO n Umcn mwn wW vc <br />CONTRACT PRICE OF WORK: S 2,900 <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />Install furlace & water tank <br />PROPOSED USE OF BUILDING <br />SFR <br />I EGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />LOT _ BLOCK — OF <br />JCB ADDRESS <br />714 Beth St. SE <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — A/HNDLG UNITS — H P. <br />BATHTUB <br />1 <br />FORCED AIR SYSTEMS — B T.U. M EA <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS —8.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />. <br />CLOTHES WASHER <br />WOOD STOVE <br />_ <br />URINAL <br />METAL FIREPLACE 6 CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLUOR DRAIN <br />HEATPUMP <br />BACKFLOW PREVENTERS <br />2 <br />GAS PIPING <br />ROOF DRAINS — RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE — BAR. ETC.) <br />BUD TOTAL <br />f <br />SUBTOTAL <br />f <br />No00 <br />PERMIT <br />t <br />PERMIT <br />f <br />TOIALFEE <br />t <br />TO <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />OM3782 <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES 0 NO <br />FEES <br />E <br />FEE _ <br />BUILDING <br />NECH $65.00 <br />DPE OF DNSTRUCTON AILNYASIE <br />TYR: OF CDNSTRMtON ACTUAL <br />° '• <br />ND Of DYALLWG (;Nil <br />PLUMBING <br />SIZE OF BlOG <br />NO OF STORIES <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />CHECK $205.00 <br />65 <br />0 <br />OCCUPANCY LOAD FIRE SPRINKLERS REO'D <br />❑ YFS ❑ NO <br />REASON FOR SPRINKLERS <br />HEIGHT LIMITATION <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />- <br />PLANS A; 'PROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS <br />3105 <br />PUBLIC WORKS <br />TOTAL <br />65 <br />210 <br />WHFN PROPFRI_Y VALIDLITED <br />THIS IS <br />YOUR PERMIT <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDRESS 111 F03 <br />378 <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />