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the <br />E`CTYeOF r- CONSTRUCTIC N <br />everett PERMIT PERMIT NO. 12013 <br />CITY HALL 259-8745 <br />EVERETT, WA 98201 0 COMBINATION BUILDING MECHANICAL ® PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />James M. Branstrom 4824 Fowler Everett 98203 252-4032 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE N <br />Same <br />MECHANICAL CONTRACTCR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE k <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N <br />V VV 11iNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />S 72,000.00 <br />PROPOSED USE OF BUILDING ` <br />Duplex <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />P FORMANCE F CONSTRUCTION. <br />SI TURE OF CONT A TOR OR AUTHORIZED AGENT DATE <br />'�v> �( ��,1.lr—� 6/2/83 <br />LEGAL f ESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT 2 BLOCK —OF- Monson Addition <br />F 6 28 5 <br />JOB AD SSJ <br />5702 Fleming <br />PLUMBING <br />A C ANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EGUIPMENT <br />FEE <br />2 <br />WATER CLOSET (TOILET) <br />4 <br />00AIR <br />COND. UNITS - H.P. EA. <br />2 <br />BATHTUB <br />dii <br />4 <br />00 <br />REFRIGERATION UNITS - H.P. EA. <br />2 <br />LAVATORY (WASH BASIN) <br />4 <br />00 <br />BOILERS - H.P. EA. <br />SHOWER.; <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />2 <br />KITCHEN SINK & DISP. <br />4 <br />00 <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />4 <br />no <br />WALL HEATERS - B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS - B.T.U. M <br />2 <br />CLOTHES WASHER <br />4 <br />0.0 <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />4 <br />no <br />2 <br />CLOTHES DRYERS <br />9 <br />00 <br />URINAL <br />4 <br />VENTILATION FAN <br />12 <br />00 <br />DRINKING FOUNTAIN <br />2 <br />RANGE HOOD <br />9 <br />00 <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />2 <br />VACUUM BREAKERS <br />4 <br />00 <br />STOVE - WOOD <br />_ <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & .:HIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUBTOTALJE3 <br />0 <br />SUBTOTAL S <br />30 <br />00 <br />PERMIT <br />PERMIT S <br />TOTAL FEE <br />32 <br />50 <br />TOTAL FEE <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />83/12013 <br />PLAN <br />FEE oZ% � <br />19%55 <br />C ECK FEE <br />(-T NO. <br />371 IP <br />652804 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />.XlES ; .NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />2 <br />BUILDING <br />372,000. <br />349 <br />00 <br />SIZE OF BLDG. <br />2375 S . Ft. <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />3 <br />PLUMBING _ <br />32 <br />00 <br />FIRE ZONE <br />BASEMENT <br />None <br />FIRE SPRINKLERS <br />REQUIRED <br />',.YES <br />MECHANICAL <br />3O <br />OO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECKLIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS a. <br />TOTAL <br />4111 <br />Or, <br />3. FIRE HYDRANT v <br />4. FIRE PROTECTION SYSTEr <br />�_AD-- G }-f„T— <br />PERMIT VALIDATION <br />NHEN PROPERLY VALIDATED (IN TIjIS�S�/�E) THIt I� Y�OI�i P�TI7I T <br />O �. O O —_ 3 jj ) 7 U U c:) <br />n <br />9 Y'`-� IJ R REC t,IYT <br />„ !'ECEIPT THANK YOU <br />ICU <br />oQbDRAINAGE, -' <br />ENVIRONIAE LIMPAC TATEMENT <br />HEALTHDZT;CT <br />CkPPLICATIOfI . BY <br />``H PE l I'll <br />�l <br />�LANS CHECKED BY <br />O <br />HWM <br />APPR. FOR ISSUANCE BY <br />LC !. <br />All <br />ADQRgS�LNLT Z <br />28JW83 <br />