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dre EverAreen �/� ����� ��I� � � <br /> c�iv cF ' <br /> everett `� P E R M I T �' <br /> PERMIT N0. �-� � 5 'I <br /> QTV HALL 259�8745 <br /> EVERETT,VJA9B20� ❑ COMBINATION � BUILDING ❑ MECHANICAL PLUMBING <br /> I�q�f] CITY ZIP PkONE <br /> OWNER MFIL PDDRE55 <br /> Snohomish 98290 568-8783 <br /> X�$��Xp, Lawler 700 Ma ie ��TY ZiP PMONE <br /> APCHRECT OR DESIGNER MAIL ApDRE55 <br /> GENERAL GONTRI.CTOR <br /> IAAIL Ap�RE55 GITV ZIP PHONE LICENSE� <br /> $y[Qe ��Ty 21P PMONE LICENSE+' <br /> L�2GHPNICFL GOP!TRACTOR IdAIL FDDPE55 <br /> PLUM9ING GONTRAGTOfl �dl.iL AOORESS <br /> CITV ZIP PMONE LICENSE M <br /> C1A55 OF YJORK <br /> ❑ NEW ❑ ADGi":iP� �F AL7ERA710N ❑REPAIR ❑ OEIdOI.ITION ❑ FENC° ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSE <br /> VALUATION OF WOFK <br /> S ZO�OOO.00 <br /> DESCRIBE YlORK <br /> New Foundation , Add dormer <br /> PROFOSEDUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEDTHIS <br /> Single Family Residence qppLICATION AtJD KNOW THE SAME TO BE TRUE AND <br /> LEGALOESCRiPt10NOFPROPERTYISHOWBELOIVOflATTACMFOURGOPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> 15-16 439 Everett Div. K GOVERiVING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT_BLOCN_OF WHETHER SPECIFIED HEREIN OR NOT.THE GRAN7ING OF A <br /> OR CANCELST�E PROVISION3 OIFEAiVY OTHIERTOT IOE OR <br /> LOCAL LAW REGULATING CONSTf�UCTION OR THE <br /> PERFORMANCE Of�CONSTRUCTION. oATE <br /> SIGNATURE OF CONT(lACT(�P OR AUTHD{I�RED AGENT <br /> J00 A�DPESS ._ l �..` � L ' r"_.� <br /> 2131 Lombard .��^ � '� ' " � � <br /> MECHANICAL� <br /> PLUMBING FEE <br /> FEE NO. TYPE OF EQUIPMENT <br /> NO. TYPE OF FIXTURE OR ITEM Alfl COND.UNITS — H.P. EA. <br /> z WATERCLOSEryTOILEn 4 00 — <br /> 2 EAiHTUB 4 OO REFRIGERATION UNITS — H.P. EA. <br /> � LAVATORY�WASH BASIN) �I OO BOILERS— H.P. EA. <br /> GAS FIRED A.C. UNITS —TONNAGE EA. _ <br /> SHOWER <br /> 1 KITCHEN SINK 8 DISP. 2 OO F09CED AIR SYSTEMS — B.T.U. M EA. <br /> WALL HEATERS— B.T.U. M <br /> 1 DISHWASHER M <br /> � UNIT H[ATERS— B.T.U. — <br /> LAUNORYTRAY <br /> CLOTHcSWASHER 2 �Q EVAPORATIVECOOLEHS <br /> CLOTHES DRVERS 4 SO <br /> WATER HEATER 2 OO 1 Fj OO S <br /> URINAL Z VENTILATION FAN 4 SO F� <br /> DFINKING POUNTAIN 1 RANGE HOOD F. <br /> AIR HANDLING UNIT — C.F.M. i. <br /> FLOOR DRPIN �� — r" <br /> - S70VE —VJOOD <br /> VACUUM BREAKEFS 'J SO <br /> ROOF DRAINS— RAINLeADERS <br /> ]. METAL FIREPLACE 8 CHItdNEY <br /> SINK�SERVICE— BAR, ETC.) <br /> FIREPLACEINSERT <br /> HEAT PUMP <br /> H F <br /> _ y r- <br /> N r <br /> SUB 70TAL S 22 SO r <br /> SUB 70TAL S 20 00 �C C <br /> PEflMIT 5 �" '- <br /> PERhIIT 5 22 50 � <br /> TOTAL FEE 5 ZO OO TOTAL fEE 5 "�' f <br /> PLAN CHECK FEE <br /> SI�E YARD SETBACK STFEET SETBACK FEAR YARD SETBACIC PLAN CHECK IvUMOER fEE 91.33 REC IPT N0. ��e+ C <br /> Existin S tbacks 83/12751 6615�3 C-i <br /> VACANT SITE FEE p� : <br /> USE ZONE LOT AREA FEES VAI.UATION <br /> YES .NO <br /> R-2 � <br /> TVPE OF GONST. OCCUPANCY GROUP NO.OF�WELLING UNITS ,� .. <br /> V-N Alter R-3 1 BUILDING b 20,000. 14 50 <br /> SIZE OF BLDG. NO.OF STORIES MA%. OCQ L�AD pLUMBING Z OO J <br /> �xisting Z <br /> FIRE ZONE 64SEMENT FIRESPRINKLERS MECHANICAL z 5� ~ � <br /> REOl11REq, h <br /> NORe . �.YES ^��� <br /> UTHER <br /> APPROVALS BY DATE U.B.Q � � � <br /> 1. cNVIRONMENTAL CHECK UST PENALTY SEC.3031a1 r: <br /> 2.BUILDINGPLANS ,�> TQTp� ISB OO �/ � <br /> 3.FIRE HYDRANT "' • <br /> PEHMIT VALIDATION ❑ <br /> 3.FIREPROTECTION SVST � � n WHEIJMPPOP�QI.Y_VILLIDA�F D pN THIS$.�'�0�)THIS�Sh'�1�F'�i�lT— , '� <br /> 5.GRADI�G _ . .. . ��.. <br /> 6.DRAINAGE O1' p /� �, <br /> �7.ENVIRONMENTALIMPACT5YATEMENT .. .)'�:L,. i-IP� � �� -• � 1`L:4EIFT � � <br /> �B;HEAL7H01¢TRICT � � - ' .;'I� ��'-. �J <br /> �APPLICATION AGC.BY �Jp�LANS GHECKED BY APPR.FORISSUANCE BY ` 4,�., U <br /> �,: . � �.—� LC <br /> STG --' � HWM <br /> r_ -,. <br /> ' _. •� ..._., ., .. , ... . . ., _ <br /> 1` <br /> - . .r`iiF.i".S �il.c <br />