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„,�Llergrpen CO N ST R U CT I C �J <br /> CiiV OF � <br /> �everett PERMIT PERM17 NO. 15�23 <br /> CITY HALL 259�8745 <br /> EVERETT,WA 98201 [� COMBINATION � BUILDING � MECHANICAL G PLUMBING <br /> OWNER MAIL AD�RESS CITY ZIP PHONE <br /> Dave Hrandvold P.O. ISox 3066 Everett 98203 355-6000 <br /> ARCMREGi OR DESIGNER MAIL AOOPESS CRV ZIP PHONE <br /> GENERAL CONTRAGTOR MAIL AOORE55 GiV ZIP PMONE LICENSE I <br /> James Camp Construction 207 188th N.t9. Arlington 98223 652-8239 <br /> MECMANICAL CONTFACTOR MAIL ADDRESS CITV 21P PHONE UCENSE M <br /> JAMESCCIG4CA <br /> PLUMOING CONTFACiOR MAIL AO�RESS GRY ZIP PHONE LICENSE M <br /> C1A55 OF WORK <br /> Q�IEW ❑ ADDITION ❑ ALTEPATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN O WOOD STOVFJFIREPLACE INSERT <br /> VALUATION OF WOPN <br /> S 67,461.00 <br /> UESCNIBE WOHK <br /> Construct Single Family Residence <br /> PROPOSED USE OF BUILDING Z <br /> Single Family Residence 1 HEREBY CERTIFY Th'AT i HAVE READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND �-. <br /> LEGAL OESCRIPTION OF PPOPERiY�SHOW BELOW OR ARACM fOUR COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES m <br /> LOT_BLOCK 1C oF Queene Anne GOVERNING THIS TYPE: OF WORK WILL BE COMPl.IED WITH •• <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> East 20' of 21 and all of 22 and 23 PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE �T <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR � � <br /> R 35 29 4 LOCAL LAW REGULATING CONSTRUCTION OR THE �n x <br /> FERFORMANCE OF CO "TRUCTION. o m <br /> J09 AOORE55 SIGNATUR OF CONTRAGTOR O AU: ORIZED AGENT ��TE C O <br /> 1705 England Avenue � ,� �_��, �^� <br /> _ —� c <br /> PLUMBING ME NICAL � m <br /> � z <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE m � <br /> 2 WA7ERCL05[TITOILEp 4 00 AIR COND.UNITS- H.P. EA. p = <br /> 1 BATHTUB 2 OO REFHIGERATION UNITS - H.P. EA. n � <br /> Z LAVATORY(WASH BASIN) 4 OO 601LERS- H.P. EA. � _ <br /> .-+ <br /> 2 SHOWER 4 00 GAS FIFEO A.C. UNI75- TONNAGE EA. � H <br /> K <br /> 1 KI7CHEN SINK 8 DISP. 2 00 FORCED AIR SYSTEMS- B.T.U. M EA. 0 � <br /> 1 DISHWASHER 2 OO WALL HEATERS- B.T.U. M � 3 <br /> LAUNDRY7RAV UNIT HEATERS- B.T.U. M � m <br /> 2 <br /> CLOTHES WASMER EVAPORATNE COOLERS m” � <br /> N <br /> WATER IIEA7ER CLOTMES ORYERS O r <br /> URINAL VENTILATION FAN n m <br /> C V1 <br /> DRINKING FOUNTAIN RANGE HOOD 3 � <br /> m <br /> FLOOR DRAIN AIR HANDLING UNIT- C.F.M. � r <br /> VACI�UM BREAKERS STOVE-WOOD ' m <br /> n <br /> ROOF ORAINS- RAINLEADERS 1 METAL FIREPLACE 8 CHIMNEY � <br /> SINK ISERVICE- BAR, ETQ) FIREPLACE INSERT "� <br /> S <br /> HEAT PUMP n <br /> Z <br /> . � <br /> S <br /> r-� <br /> N <br /> � SUB TOTAL S SU9 TOTAL 5 2S 50 z <br /> O <br /> PEHMIT 5 PEHMIT S � <br /> TO7AL FEE S 22 00 TOTAL FEE S 25 50 n <br /> m <br /> SIDE YARD SETBACK STREET SE7BAGK REAR YARD SETBACK PLAN C;1ECK NUMBER PLAN CHECK FEE <br /> 6� 20' 20� FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE 96 15923 189.8 83118 <br /> R-1 8400 SCj. Ft. XNES _INO _ FEES VACUATION FEE <br /> TYPE OF CONST. OCCUPANGY GROUP NO.OF DYlELLING UN�TS <br /> V-N R-3--M 1 � <br /> SIZE OF BLDG. �.'O.OF STORIES MAX.OCC. LOAD — 6:11LOING 5 67,461. 337 00 <br /> 2761-R3 Z PLUMBING ZZ 00 <br /> 4� .. NE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED ZS SO <br /> VES NO <br /> APPNOVALS BY DATE OTHER <br /> 1. ENVI(iONMENTAL CHECK LIST PENALTY U.B C. <br /> SEC.909(a) <br /> 2.BUILDING PLANS 3H4 SO <br /> 3.FIREHYDRANT `��' TO7AL <br /> 4.FIRE PROTECTION SYSTEM-; PERMIT VALIDATION <br /> S.GRADING � WHEN PROPERLY VALIDATED(IN THI�§Pr.6�1 THISQ�SSYaUa P�F�IIL (�'p <br /> 6.DRAINAGE �' , 1� •� C �� 1 L. !1 Q ___ ^ � <br /> �� `-J <br /> 7.ENVIRONMENTALIMPACTSTATEMENT <br /> 8_HEALTH DISTRICT �-� � ,; i;,,(,i,_i(I � <br /> ARPLICATION ACC. 8Y PIANS CHECKED BY APPR. FOR ISSUANCE�.BY . ,.' �.� '' I .. ; � r �J <br /> .li i . i � <br /> --� �._n J�F . . . . . � � <br /> r _� <br /> `_ <br /> . ' ' . ...� i ! <br /> �. J <br /> ADDRESS��FlI.Ei � � <br />