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r <br />die Erer,¢rcen �� ^ O f�l ST R U CT I O R, <br />Giv OF � <br />everett PERMIT PERMIT N0. 13604 <br />CITY HhLL 259�8745 <br />EVERETT,WA98207 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRE55 CITY ZIP PHONE <br />Abner hf. Wagner 5029 Crest Lane Everett 98203 252-8128 <br />ARGMITECT OR DESIGNEP MAIL AODRE55 GTY 21P PMONE <br />GENERPL CONTRnGiOR MAIL ADDRE55 CITY ZIP PMONE UGENSE • <br />Same <br />MECHANICALGONiRACTOR MAILADDRESS CITV ZIP PNONE LIGEhSE� <br />PLUMBING GONTRPCiOR MAIL ADDRE55 CITY ZIP PHONE LICENSE � <br />❑ NEW ❑ ADDiTION $X ALTERATION � REPAIR ❑ DEMOLITION ❑ FENGE O SIGN ❑ WOOD STOVFJFIREPLAC[ INSERT <br />S 500.00 <br />iCRIBE WORK <br />Construct <br />single family residence <br />�or 4 aiocK 0� <br />36-29-4 <br />5029 Crest Lane <br />PLUMBINO <br />TYPE OF FIXTURE OR ITEM <br />W ATEfi CLOSET (701LEn <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK d DISP. <br />LAUNDRY7RAY <br />CLOTMES WASHER <br />WA7EP.HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DFiAIN <br />VACUUM BFEAKERS <br />FOOF DRAINS — RAINLEA�ERS <br />SINK (SERVICE — BAR. ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />SETBACK STFEETSETBAC <br />X 6' 20' <br />LOT AfiEA <br />R-1 <br />',ON57. OCCUPANCY GR <br />V-N R-3 <br />LDG. NO. OF STORIE: <br />i <br />APPROVALS <br />^ 1. ENVIRONMENTAL CMECK LIST <br />2. BUILDING PLANS <br />3. F�F7E HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />� 7.ENVIRONMENTALIMPACTSTAI <br />B. HEALTM DISTRICT <br />�B <br />JEF <br />BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AMD 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 STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />..�....,.nCnE muroecme rm nIrtHOR2ED AGENT _ �ASE / <br />MECHANICAL <br />FEE NO. TYPE OF EUUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — M.P. EA. <br />GAS FI(7ED A.C. UNITS — 70NNAGE EA. <br />FORCE� AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATEFS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPO(7ATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR NANOLING UNIT — C.F.M. <br />S70VE — WOOD <br />METAL FIREPLACE 8 GHIMNEY <br />FIREPLACEINSERT <br />MEAT PUMP <br />S _ <br />S <br />REAR YARD SETOACK PLAN CHECK NU <br />20� 84/13604 <br />VACANT SITE FEE <br />ves x�it° <br />NO. OF �WELLING UNITS <br />1 BUILDING <br />MA%.00C.LOAD <br />PLUMBING <br />FIRE SPRMKlERS MECHANICAL <br />YES ' NO <br />BY DATE <br />IISSUANCE <br />I,C <br />OTHER <br />SUB TOTAL <br />TOiALFEE <br />PLAN <br />F�E 6.50 <br />VALUATION <br />s500. <br />FEE <br />� <br />5 <br />S <br />�HECK FEE <br />RECEIPT NO. <br />70719 _ <br />FEE <br />10 00 <br />PENALTY SEC 303 (a) <br />TOTAL 10 00 <br />PEHMIT VALIOATION <br />WHEN PROPERLV VALIDATED (W THIS �SPAQE) THI�I$�VQI{�i P�Fj¢11T �(�' <br />� I tS U I U U <br />V7 <br />(`7 <br />, n � <br />- „ . .. � I" � r_� <br />... `� �i <br />ADDRESS FILE <br />i. 'i <br />� j . _� u, <br />� <br />� <br />a <br />� <br />