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11r <br />1 <br />7 <br />E. <br />t "' 0'ONSTRUCTIOP' <br />Tq . I <br />everett PERMIT PERMIT NO. 12026 <br />CITY HALL 259-BT45 <br />EVERETT, WA 99201 KX COMBINATION ❑ BUILDING C MECHANICAL ❑ PLUMBING <br />OWNER M I CITY ••••••� <br />MICHAEL AWTREY 20831 FAAKAD BPI�'�ERS RD STANWOOD 259-'5977 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />SAME <br />CITY <br />ZIP <br />PHONE <br />BLUESC 178 ON <br />LICENSE, <br />MICHAAMUMAMOSTRUCTION <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE, <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />��^,� V • v^XQ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE <br />VALUATION OF WORK <br />s 29,580.00 <br />❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />11CW zI 11yj c lamij , .��••�- <br />PROPOSED USE OF BUILDING <br />CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />single family residence <br />I HEREBY <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />SP1202-2-83 <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT 1 BLocK_o= <br />WHETHER SPECIFICD HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TOVIOLATE <br />Legal description attached <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. DAIL <br />IGNATURE F CONTR O TH04 tLLNI 6/6/83 <br />JOB ADDRESS <br />6924 Colby <br />SA k <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />N0. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOILETi <br />AIR COND. UNITS - H.P. EA. <br />REFRIGERATION UNITS - H.P. EA. <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />BOILERS - H.P. EA. <br />_ <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />SHOWER <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />KITCHEN SINK A DISP. <br />1 <br />DISHWASHER <br />2 <br />WALL HEATERS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />LAUNDRY TRAY <br />1 <br />CLOTHES WASHER <br />2 <br />OQ <br />EVAPORATIVE COOLERS <br />4 <br />50 <br />1 <br />WATER HEATER <br />2 <br />00 <br />1 <br />CLOTHES DRYERS <br />3 <br />00 <br />1 <br />VENTILATION FAN <br />URINAL <br />1 <br />RANGE HOOD <br />4 <br />5O <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT - C.F.M. <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE -WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE A CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />f <br />14 <br />00 <br />SUB TOTAL f <br />12 <br />OO <br />PERMIT <br />f <br />f 14 OO <br />PERMIT f <br />TOTAL FEE f 12 OO <br />TOTAL FEE <br />SIDE YARD SFT13ACK STREET SETBACK <br />REAR YARD'.ETBACK <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />RECEIPT NO. <br />6 ft 20 ft <br />20 ft <br />83/12026 FEE 125,45 <br />USE ZONE LOT <br />AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />RYES LNO <br />R-1 <br />TYPE OF CONS7. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />V-N <br />R-3 <br />1 <br />BUILDING <br />f29 580.00 <br />193 <br />0 <br />SIZE OF BLDG, NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />14 <br />00 <br />816 sf 1 <br />3 <br />— <br />FIRE ZONE BASEMENT <br />FIRE SPRINKLERS <br />REOUI <br />MECHANICAL <br />12 <br />00 <br />YES NO <br />ER <br />APPROVALS <br />BY DATE <br />OTHER <br />U.B.G. <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SEC. 303 (a) <br />2. BUILDING PLANS '11 <br />TOTAL 219 00 <br />3, FIRE HYDRANT <br />4. FIRE PROTECTI N SYSTW6 <br />VALIDATION{�� pp qq .(� ((�� <br />ALID TIOVALIDATEO <br />PERMWREN HIS'S'AY0 THIS ♦ �OURJ'"T J--Ty <br />5. GRADING_�'T <br />PROPERLY IIW <br />p C\ <br />C <br />"I _-4-4 Q •J`.; IJR RECEIPTC\ <br />'• <br />O� ;j to T- � AN K Y O U <br />6. DRAINAGE L- <br />O7-ENVIROWAE 0LIMPAQS$TATEMENT <br />50 HEALTH 046T I T <br />BY <br />LANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />PLICATI . <br />Cs -< () <br />=31 <br />f A ;;a N <br />L" ® M <br />H W M <br />LNC <br />oo { M d <br />1 <br />w <br />C -0 <br />ADDRESS FILE —I <br />