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I <br />d„• £rereTLN•„ <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />CONSTRUCTION <br />PERMIT <br />❑ COMBINATION U BUILDING ❑ MECHANICAL <br />PERMIT NO. 14451 <br />❑ PLUMBING <br />OWNER <br />M:I'. ADDRESS <br />CITY <br />ZIP <br />PHONE <br />William Southey <br />4631 Darlington Lane <br />Everett <br />98203 <br />355-7892 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />ENeRA L CONTRA TOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE 0 <br />I�ort1i Sound Builders <br />9208 Highway 99 North <br />Marysville <br />98270 <br />653-2512 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE 0 <br />NORTHB228J4 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE I <br />❑ NEW YADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S 11,000.00 <br />DESCRIBE WORK <br />1111v9f)' LAA4l inn to nvi chinrt rociflnnnn <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />tingle Family Residence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LEGAL DESCRPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />15-16 4 Queen Anne <br />GOVERNING THIS TYPE OF W013K WILL BE COMPLIED WITH <br />LOT_BLOCK_OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />_--- <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMA�CO TRUCTAGN. <br />SIGNAiURP,�F T ACTOR OP TNO'lIZEO AGENT DATE <br />JOB ADORE:- <br />1631 Darlington Lanel/ <br />MEC AN,CAL <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEEN! <br />YPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NITS — H.P. '-A. <br />BATHTUB <br />ION UNITS — N.P. EA. <br />LAVATORY (WASH BASIN) <br />H.P. EA. <br />SHOWER <br />.C. UNITS — TONNAGE EA. <br />ITS <br />KITCHEN SINK A OISP. <br />SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />RS — B.T U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />_ <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMPTAL <br />pFDAIN—RBAINEBACD,0EMR______S <br />S <br />SUB TOTAL 1 <br />1 <br />PERMIT S <br />TOTALFEE <br />1 <br />TOTAL FEE 1 <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />6' <br />20' <br />20' <br />85/14451 <br />FEE 5G. 23 <br />7SyPT NO, <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />R-1 <br />YES XXNO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />1 11,000. <br />86 <br />50 <br />V-N <br />R-3 <br />1 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />add' n 360 Sq. F. <br />1 <br />N/A <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />HEIDEN <br />none <br />YES 7 YO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1, ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />86 <br />150 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN 141S'SPAt. CE) THIq19ff� `E, Y ET(M IT <br />�'II I — <br />GRADING <br />.I <br />!FT <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />0. HEALTH DISThICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />EB <br />HWM <br />LC <br />I•� <br />it <br />i <br />e�I <br />ADDRESS FILE <br />