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the `"` CITY f I� INSTRUCTION CITY OF <br />everett PERMIT PERMIT NO.. 23958 <br />259-8810 <br />❑ DEMOLITION I] COMBINATION ❑ BUILDING Q MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY :JI' PHONE <br />_ Robext Smith RT7 AAt_M ct cF r n rr QR�n1 355-OSF1 <br />TENANT MAIL ADDRESS CITY PIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />MAIL ADDRESS <br />CITY <br />PHONE <br />CITY ZIP PHONE LICENSE F <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />VA11ey Nat ERR <br />2AnS MPnnl(; 1 1: P <br />*t QR7n1 21;Q-S000 <br />VLTTENG15110 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION N ALTERATION ❑ REPAIR ❑ DEMOLITION D BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO IF OTHER THAN ABOVE <br />CONTRACT PRICE OF WORK $ 4900.00 <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />Install furnace and water heater <br />PROPOSED USE OF BUILDING <br />SFR <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />LOT - BLOCK - Of <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EWttM <br />WATER CLOSET (TOILET) <br />NC - ArHNDLG UNITS - H P. <br />BATHTUB <br />1 <br />FORCED AIR SYSTEMS - B mom_ <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS - S.T U mrrw M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK S DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />1 <br />WATER WAATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE 6 CHIM <br />DRINKING FOUNTAIN <br />FIREPLACEINSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />2 <br />OAS PIPING <br />ROOF DRAINS - RAINLEADERS <br />JEXHALISTFAN <br />SINK (SERVICE - BAR. ETC.) <br />SUB TOTAL <br />f <br />SUB TOTAL <br />IT <br />70 <br />OO <br />PERMIT <br />f <br />PERMIT <br />f <br />15 <br />00 <br />TOTALFEE <br />S <br />TOTALFEE <br />f <br />1 85 <br />00 <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />BUILDING CODE <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYR: OF CONSTRUCTDNAILDWARU <br />TYPE OF CONSTRUCTMIACTUAL <br />°f p Y <br />ND DF DWFI LINE. UhUS <br />PLUMBING <br />_ <br />SIZE OF BLOC <br />NO OF STORIES <br />BASEMENT <br />YES D NO <br />MECHANICAL <br />65 <br />00 <br />OCCUPANCYLOAD FIRE SPRINKLERS RED D <br />0 res ❑ No <br />REASON FOR SPRINKLERS <br />HEIGHT LIMITATION <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />S. <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS <br />3105 <br />PUBLIC WORKS <br />TOTAL <br />AS <br />00 <br />WHEN PROPERLY VALIDATED <br />THIS IS <br />YOUR PERMIT <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDRESS FILE 23958 <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />