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Vwm <br />rtLeeDeITY OF CITY C INSTRUCTION <br />i <br />everett PERMIT PERMIT NO. 20102 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION [2 BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OV.NER MAIL ADDRESS CITY ZIP PHONE <br />Deaconess Children's Services 4708 Dogwood Dr. Everett, WA <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Ed Burby & Assoc. 18105 - 47th Ave SE Bothell, WA 98012 338-0231 EDBURNS Z8$ 134 MS <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSEY <br />CLASS OF WORK <br />L NEW ❑ ADDITION ® ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S 1200. <br />DESCRIBE WORK <br />Open north end wall. lower level, and install exit door, landing & steps <br />HEAT SOURCE <br />❑ ELECT•10CITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />offices <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 <br />EL THE PROVISIONS OF ANY OTHER <br />VIOL*OAL <br />STATLAW REGULATING CONSTRUCTION OR <br />THEOF CONSTRUCTION. <br />SIGNATAUTl�C RIZEO AGENT. OR OWNER C DATE <br />X <br />LEGAL DESCRIPTION OF PROPERTY (SHOW RELOW OR ATTACII FOUR COPIES) <br />90 Forest Park Add "A" <br />LCT _ BLOCK _ OF <br />JOB ADDRESS <br />4708 Dogwood Drive <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIC-A/HNDLG UNITS - N.P. <br />_ <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />I WATORY(WASH BASIN) <br />BOILERS -B.T.U/H. P. <br />SHOWER <br />GAS FIRED AC. UNITS — B.T.U. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />DISHWASHER <br />WALL HEATERS—B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS —B.T.0 M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />°LOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVLNTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR. ETC.) <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />S <br />SUBTOTAL <br />PERMIT <br />S1 <br />PERMIT <br />TOTALFEE <br />S <br />TOTALFEE <br />FRONT SETBACK <br />20' <br />REAR SETBACK <br />20' <br />SIDE SETLACK <br />6' <br />PLAN CHECK NUMBER <br />88/20102 <br />FEE <br />18.85 <br />RFdE1PT NO <br />97684 <br />USE ZONE <br />R-1 <br />LOT AREA <br />VACANT SITE <br />❑YES MO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />S 1�JO.00 <br />29 <br />00 <br />TYPE OF CONST <br />V-N <br />OCCUPANCY GROUP <br />B-2 <br />NC OF DWELLING UNITS <br />0 <br />PLUMBING <br />tl5/18; 88 2:4 <br />PM 000AHOL53 <br />:k**: <br />SIZE OF BIDG <br />NA <br />NO. OF STORIES <br />NA <br />MAX. BCC. LOAD <br />NA <br />MECHANICAL <br />/ <br />FIRE SPRINKLERS REQUIRED ❑ YES CkNO <br />INVESTIGATION FEE <br />0.00029192 <br />K.OU '041") 120.00 <br />STATE BUILDING SURCHARGE <br />G $F:LM Vi.50 <br />3 <br />50 <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />M.M. <br />-- <br />PLANS CHECKED BY <br />Be <br />MPR FOR ISSUANCE <br />Be <br />BY <br />DRIVEWAY PERMIT <br />TOTAL <br />eeoulr vwI mennu <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />N <br />G <br />CD <br />