5904 LOMBARD AVE 2018-01-02 MF Import

the Evergreen CITY OF everett CITY HALL 259 8745 EVERETT. WA 98201 CONSTRUCTION • PERMIT • COMBINATION • BUILDING • MECHANICAL • PLUMBING ,,e everett OWNER MAIL ADDRESS ZIP PHONE NE=Kd Kelly XXXXWX&X%jK{ Olive Kelley 5904 Lombard 3 -7417 m ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. GENERAL CONTRACTOR - MAIL ADDRESS PHONE LICENSE NO. Everett Builders 5606 Evergreen Way 353-7161 EV ER EB 301PH z C MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. GO Ur m PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. 6r PERMIT ❑�yyCOMBINATION (_y EIUILDING ❑PLUMBING ❑MECHANICAL CLASS OF WORK ❑NEW ❑ADDI TIUtJ ❑ALTERATION RREPAIR VALUATION OF WORK $ 3910.00 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL DESCRIBE WORK 41XXM4L4{X X Install concrete Block foundation PROPOSED USE single family residence MECHANICAL TYPE OF ENERGY ❑GAS ❑ELEC. LLGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR AT T ACH P OURC IES. LOr BLOCK 11 OF Laurel Heights — NO. TYPE OF EQUIPMENT FEE AIR COND. UNITS-H.P. EA. $ I REFRIGERATION UNITS-H.P. EA. BOILERS H.P. EA. I FORCED AIR SYSTEMS-B.T.U. MEA. JOB ADDRESS 1HXXi605}4X4C}t,7E1fd�M 5904 Lombard SPACE WALL HEATERS -B.T.U. UNIT HEATERS--A.T.U. 1 PLUMBING EVAPORATIVE COOLERS CLOTHES DRYERS 1 VENTILATION FAN �- RANGEHOOD I NO. TYPE OF FIXTURE OR ITEM FEE AIR HANDLING UNIT- C.F.M. BATH TUBS $ I CLOTHES WASHER I WATER HEATER DISH WASHERS I - FAC. BUILT FIREPLACE &CHIMNEY DRINKING FOUNTAINS I FLOOR DRAINS I GAS. SYSTEM: NO OP OUTLETS KITCHEN SINKS & DISP. I SUBTOTAL $ I BAR SINKS PERMIT $ TOTAL FEE $ I ROOF DRAINS - RAIN LEADERS SHOWER BATHS THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRFCT. 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 CONSTRUCTION. 4/30/79 -30-%9 SERVICE SINKS SUMPS - SEWAGE PUMP URINALS WATER CLOSETS WATER HEATERS - ELECTRIC 1 WASH BASINS I LAUNDRY TRAYS I SUB TOTAL PERMIT $ A EE WATER SERVICE SIZE BLDG. SUPPLY SIZE SIC-5ATUREOFCONTRynORORAUTH.AGENT DATE SIDE YARD SETBACK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USEZONE LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPE OF CONST. OCCUPANCY GROUP UN.I OSF DWELL114G 1 BUILDING $ 3910.00 28 1 00 SIZE OF BLDG. NO. UP SIURIES MAX. OCC LOAD PLUMBING FIRE ZONE BASEMENT PIKE REQUIRED SPRINKLERS OYES []NO _ MECHANICAL I SPECIAL CONDITIONS: OTHER 1 1 PENALTY SEC. 3031a1 --- TOTAL _ 28 100 — - PERMIT VALIDATION P VALIDATION _t629.60 l WHENVALIDATED II4 PAC sI W RTC}7MH cn YOUR RECEIM* THANK YOU cn g I uIv '7n - —----------- --- AWLIGTIONACCEPTEUOY JPIANtiO4UKIIIUY 770111:5UPNCl by is i? ESS FI LE + I RA1 1 7