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`��""�' � C")NSTRUCTION - ^ C <br /> ��„ �,F <br /> everett PERMIT PERMITN4 . �� � �`� <br /> ❑ DEMOIITION f.� COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> ppryEp MMl AODFESS CITY ZIo PMONE <br /> Rick Graff 19125 N. Creek Pkwy #111 IIothell 98011 483-0909 <br /> ARCMITECT UR DESIG.ER MFiI rIUfJRE55 QLY ZIV PNONE <br /> Flynn & Asaoc. 1140 140th Ave. NE Bellevue 98005-2996 643-5100 <br /> GENENAt CONTMCTOB MAR ADDPE55 CiTY ZIP PMONE IICENSE X <br /> Bellwether Homes 19125 N. Creek Pkwy #111 Hothell 98011 483-0909 <br /> NECHANICAICONTNFCTOR MAILADORE55 CITV 21P VNONE LICENSE• <br /> MUMBINGCONTRACTON MRIIR�ORESS CIiY ZIP PMONE LICENSEM <br /> LLASS OF WOPN <br /> fja NEW ❑ ADDITION ❑ Al7ERATION ❑ REPAIR O DEMOLITION ❑ BUILDING HELOCATION <br /> V�LUPTION OF WORK � <br /> s 94,015.00 <br /> oeseaiee wonK <br /> Construct single family residence <br /> HEATSOUACE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE O OTNER <br /> PROFOSED USE OF B W I�ING <br /> Single family residence I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCRIGTIONOFPROPERTYISHOWBELOWORATTPCHFOURCOPIESI CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or 6 e�ocK _ov $lack Forest Iane GOVERNING THIS TYPE OF WORK WILL BE COMPI.IED WITH <br /> � WHETHEfi SPECIFIED HEREIN OR NOT. THE GRAP�.71NG OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTFlORITY TO <br /> VIOLATE OR CANCEL T �� PROVISIONS OF ANV OTHER <br /> STATE OR LOCAL LAW GULATING CONSTRUCTION OR <br /> ORMANCE OF STRUCTION. <br /> JOB ADDRESS SIGNPTURE F CO RNCTO .AUT O 12E0 HGENT,OR OWNEF TE <br /> 4922 Black Forest Iane X � <br /> PLUMBING ME HANICAL • <br /> NO. TYPE OF FURUHE OH ITEM FEE NO. TYPE UF EOUIPMENT FEE <br /> 2 WATER CIOSET(TOIIET) ZO OO A/C—A/HN�LG UNITS—H.B . <br /> 2 BATHTUB LO OO REFRIGERATION UNITS—H.P.EA. <br /> 3 LAVATORY(WASHBASIN) SS OO BOILERS—BT.UJHP. <br /> 1 SMOWEF � S OO GAS FIRED A�G UNITS—B TL. <br /> 1 KITCHEN SINK&DISP. S OO S FORCED Alfl SVSTEMS—B.T.LL M EA. 9 OO <br /> 1 DISMWASHEfi S OO WALLHEHTERS—B.T.U. M <br /> 1 LAUNDRYTflAY S OO� UNITI.EATERS—B.T.U. M <br /> 1 CLOTHES WASMER S OO EVAPORATNE COOLERS <br /> URINAL j CLOTHESORYERS SO <br /> ORINKING FOUNTAIN Z VENTI�ATION FAN B OO <br /> F�OOR DRAIN I RANGE HOOD G SO <br /> BACKFLOW GREVENTERS 1 WATER HEATER � 6 SO <br /> ROOF ORAINS—RAINLEADERS WOOD SiOVE <br /> SINK(SERVICE—BAR.ETCJ METAL FIREPLACE 8 CHIMN <br /> FIREPLACE INSERT <br /> HEAT PUMP <br /> GAS PIPING <br /> EXHAUSTFAN ` <br /> sue rotn� s 60 00 sue 37 50 <br /> � VEPMR S �pM <br /> TOTALFEE f EO OO TOTA 7 <br /> FnOrR SEiBACK AEnR SE*BnGK S�oE SETBaCK PLAN CHECK NUMBER F IPT NO. <br /> 88/21155 11 -58 � 3• 423 <br /> USE 20NE LOT AREA yqCRNT SRE <br /> [IrEs �JHo FEES VALUATION FEE <br /> TYVEOFCONST OLCUGANCVGROUG NOOF�WELL�NGUNITS BUILDING S94 15. 61'� Q <br /> V—N R-3 1 PLUMBING <br /> SIZE OF BLOG �JO.OF SIOiVIES MA%.OCC LOAD 6O OO <br /> 2135+432 G 2 N/A MECHANICAL 3'] rje <br /> INVESTIGATION FEE Sec.304(e) �O 20 <br /> FIRE SPRINNLERS REOUIFEO ❑VES NO STATE BUIIDING SURCHAflGE <br /> 5 <br /> STATEENERGVSUACHARGE S O <br /> APPt�CAT�ONRCC BY GLANSCHELKE�BY APFP FORISSU/NCEBV <br /> DRIVEWAV PERMIT ZO OO <br /> TOTAL <br /> M.M. B.E. B.E. <br /> VERMIT VALIDAiION <br /> WHEN PROPEFLY VALIDATED�1N TH:S SFACE�THIS IS VOUR PERMIT <br /> �n <br /> � <br /> � <br /> � <br /> N <br /> J <br />