4821 DOVER ST 2018-01-02 MF Import

OL CITY OF theEvavven CONSTRUCTION ~ ever ett PERMIT PERMIT NO. 17102 ❑ DEMOLITION ® COMBINATION &I BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN OWNER MAIL ADDRESS CITY ZIP PHONE Alan Ostman P.O. Box 2327 Lynnwood, WA 98036 778-0000 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE Ron Johnson 19601 23rd NW Seattle 546-2288 GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE Owner MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE II CLASS OF WORK F1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION -9,000 Single family residence HEATSOURCE FI ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER PROPOSED USE OF BUILDING Single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTR CTION. SIGNATURE �ORTRACTO'T O i_OWNER DATE X ��n LEGAL DESCRIPTION OF PROPERTY (SHOW BELOWOR ATTACH FOUR COPIES) LOT _BLOCK __ OF Lots 13, 14, W 15' of Lot 15, Block 10, Queen Ann- AAj ruerett —ta JOB ADDRESS 4821 Dover St. PLUMBING MECHANICAL NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE 2 WATER CLOSET (TOILET) 10 00 A/C - A,HNDLG UNITS — H P BATHTUB 10 00 REFRIGERATION UNITS — H P. EA LAVATCRY (WASH BASIN) 10 00 BOILERS — B T.U,H P. 1 SHOWER 5 00 GAS FIRED ABC. UNITS — BTU. 1 KITCHEN SINK & DISP. 5 00 FORCED AIR SYSTEMS — 8 T U. M EA. 1 DISHWASHER 5 OO WALL HEATERS — B.T.U. M LAUNDRY TRAY UNIT HEATERS — B.T.0 M 1 CLOTHES WASHER 5 00 EVAPORATIVE COOLERS URINAL 1 CLOTHES DRYERS 6 50 DRINKING FOUNTAIN 2 VENTILATION FAN 9 00 FLOOR DRAIN 1 RANGE HOOD 6 50 BACKFLOW PREVENTERS 1 WATER HEATER 6 50 ROOF DRAINS - RAINLEADEPS WOOD STOVE SINK (SERVICE - BAR. ETC) METAL FIREPLACE A CHIMNEY FIRLPLACE INSERT HEAT PUMP GAS PIPING EXHAUSTFAN SUBTOTAL $ 50 00 SuegPIPRA 2 7% 2_4§ 5Q � : PERMIT $ - PERMIT - - TOTALFEE $ 50 00 TOT ^ 111 28 50 FRONT SETBACK REARSETBACK 20' SIDE SETBACK 10, PLAN CHECK NUMBER 86/17102 FRN $45 QQ$.43 $5 jWEIPT NO. ,00 81a 81843 USEZONE R-1 LOT AREA 8476 sf VACANT SITE (*YES ONO FEES LIATION jU FEE BUILDING 00 Sl 00 455 00 TYPE OF CONST. V-N OCCUPANCY GROUP R-3 NO. OF DWELLING UNITS 1 PLUMBING D"I' $2 .00 30 00 SIZE OF BLDG 1854 + 384 NO. OF STORIES 2 MAX OCC LOAD MECHANICAL _ Jo 4n Z^ 28 50 FIRE SPRINKLERS REOUIRED ❑ YES ❑ NO INVEST IGATION FEE N090D0i1 STATE BUILDING SURCHARGE ? 1 50 STATE ENERGY SURCHARGE ,SEWER $3 ).00 APPLICATION AFC BY M. M. PLANS CHECKED BY SG APPR FOR ISSUANCE❑Y L.C. DRIVEWAY PERMIT A IL a .0 0.00 R XRO TOTAL CHECK 4255 .32 570100 PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT CJ CD tom' r� ADDRrSS FILE