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the E°e011 W O C" NNSTRUCTION q qq { <br />everett PERMIT PERMIT NO, - 19`� 17 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL fl PLUMBING ® SIGN <br />OWNER MAIL ADDRESS CITY ZIP °HONE <br />Lindal Cedar Homes 9606 Evergreen Way Everett WA 9B204 --- <br />ARCHRECTORDESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSES <br />Superior Elect 9117 151st N E Redmond WA 98052 881-0201 supp.RE-.T 47TM <br />MECHANICAL CONTRACT OR MAIL ADDRESS CITY IP PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORN <br />❑ <br />NEW El ADDITION El ALTERATION REPAIR El DEMOLITION ❑BUILDING RELOCATION <br />5 1400.00 <br />INstall 1 D/F inte3XAl illum. pole sign <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Retail <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 />GOVERNING THIS TYPE •JF WORK WILL BE COMPLIED WITH <br />LOT _ BLOCK _ OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A. <br />PE DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VI LAT OR CANCEL THE PROVISIONS OF ANY OTHER <br />S ATE R LOCAL LAW REGULATING CONSTRUCTION OR <br />HE P FORMA E OF O RU ION. <br />GNA U EOF COAT AC fLA fH A EN OWNER DATE <br />�L <br />JOB ADDRESS <br />9609 Ever Teen Way <br />PLUMBING <br />CHANICAL f <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET( <br />A/C-A/IiNDLG UNITS - H P. <br />- <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS - B.T.0 /H.P. <br />_ <br />SHOWER <br />GAS FIRED A.C. UNITS - B T.U. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS -- R.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS-R.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE CUTLERS <br />'URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />_ <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PRFVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR, ETC.) <br />METAL FIREPLACE &CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP _ <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />$ <br />SUBTOTAL <br />PERMIT <br />S <br />PERMIT <br />TOTALFEE <br />5 <br />TOTALFEE <br />FRONT SETBACK <br />REARSETBACH SIDE <br />SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />❑SE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />rEE <br />❑ YES C NO <br />PUILDING <br />5 <br />9 <br />OO <br />TYPE OF COAST <br />OCCUPANCY GROUP <br />NO OP DWELLING UNITS <br />'UMBING <br />SIZE OF BLDG. <br />NO OF STORIES <br />MAX OCC LOAD <br />- <br />MECHANICAL <br />INVESTIGATION FEE <br />Sec. 304(e) <br />FIRE SPRIWCLERS REOUIRED ❑ YES ❑ NO - <br />STATE BUILDING SURCHARGE <br />+L <br />STATE ENERGY SURCHARGE <br />U00090a2 <br />_ <br />AP <br />APPLICATION ACC BY PLANS CHECKED BY PP FORISSUANCE BY <br />DRIVEWAY PERMIT <br />S.H. B.E. <br />L_ <br />TOTAL <br />9 <br />00 <br />- PERMIT VALIDATION <br />.._ <br />.- <br />WHEN PROPERLY VALIDATED (IN THIS SPAUq Inla IJ .van FEF., <br />r' <br />C}' <br />Q7 <br />T— <br />AFDP: <' F111 <br />