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„��.,,��.�..��.,, ''ONS�'RUCTlON <br />c�,,�� i <br />everett PERMIT PERMIT h0. � 3� �� <br />CITV HALL 259�8745 <br />EVERETT.V�A96207 j� COM8INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OCINER �AAILADDRE55 CITY 21P PHONE <br />JOHN DE WISPELAIRE 587_4 Lowell Road Everett WA 98203 355-2544 <br />FHGHREGT OR DESIGNEP MAIL A��RE55 CITY 21P PMONE <br />GEtIFRAL GONiRACTOR MAIL AD�RESS GTY ZiP PMONE UCENSE • <br />THREE LAKES CONST 6523 - 171st Ave SE Snohomish WA 98290 568-4616 <br />MECHAIllLRL CONTRAGTOR MAI� AOORFSS CIiY ZiPTHREELC20.YP�E LIGENSE F <br />GLUMBING LO.'ITRAGTOR MAII .DDRESS GIiY ZIP PNONE UGENSE M <br />❑ NEW l}Q ADDITION ❑ ALTERATION ❑ HEPAIR ❑ DEMOLITION ❑ FENCE ❑ SIG1J ❑ WO00 STOVFJFIREPLACE INSERT <br />VALUATION OF WOPK <br />i 10,800.Ci/ <br />oescn:9e woa� <br />Add 18' x 24' family room, bedroom, bath <br />PROPOSED UcE OF BUILOING <br />Single family residence <br />lOT 5 BLOCK 4 OF <br />JO� AO�FE55 <br />PLUMBING <br />NO. TYPE OF FIXTURE i�R ITEM <br />1 WATERGI.OSET�TOILEn <br />BATHTUB <br />SHOWER __ <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WP.SHER <br />WATER HEATEF <br />URINAL _ <br />DRINKING FOl1NTAIN <br />FLOOR DFA�N <br />VACUUM BREAKEFS <br />ROOF DRAINS - RAINLEAOEfiS <br />SINK ISERVICE - BAR, ETC.) <br />SUB TO7AL <br />PERMIT <br />TOTAL FEE <br />V-N I R-3 <br />SIZE OF BLDG. NO. OF STOf11ES <br />addn 432 sf 1 <br />FIFE ZONE BASEMENT <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUIL�ING PLANS �� ^i <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SVSTELIS <br />5. GRADING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APFLICATION AN� i(NOW THE SAME �7 BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPE(:IFIED HEREIN OR NOT. THE GFANTING OF A <br />PERMIT DOES NOT PR'eSUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PPOVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULAiING CONSTRUCTION OR THE <br />PERF�ANCE OF CONSTRUCTION. <br />vIG( AT IRE O�ONTRA�ORQR AU`, f112ED 4'GENT — D/TE <br />� � �� <br />MECHANICAL <br />FEE NO. TYPE OF EQUIPMENT FEE <br />AIR COND. UNITS - N.P. EA. <br />REFRIGERATION UNITS - H.P. EA. <br />Z BOILERS - H.P. EA. <br />Z UO GAS FIRED A.C. UNITS - TONNAGE EA. <br />FORCED AIR SVSTEMS - B.T.U. M EA. <br />WALL HEATERS - B.T.II. M <br />UNIT HEATERS - B.T.U. H <br />EVAPORATIVE COOLE(iS <br />CLOTHES DRYERS _ <br />]. VENTILATiON FAN <br />RANGEH.^.OD <br />AIR HANDLING UNIT - QF.M. <br />STOVE - WOOD <br />METAL FIREPLACE 8 CHIMNF.Y <br />� FIREPLACEINSERT _ <br />S <br />s 6 <br />REAR YARD SETBA( <br />VACANT SITE <br />i_YES _�:NO <br />NO. OF OWELLING <br />1 <br />h7AX. OCQ LOAD <br />FIRE SPRINKLERS <br />REQUIRED <br />.'YES I�:NO <br />ev DA7E <br />� T ENVIRONMENTAL IMPAGT$Tq7EMENT <br />' & HEALTH DISTRICT ��-�� <br />'APPUCAT16N ACG. BY '-�PLANS CHECHED BY APPR. <br />� � �� <br />4.� <br />�.-.- EB - . :� H4II4 I.0 <br />: r 't' <br />_, 'I <br />G�� <br />SUBTOTAL S <br />PEfiMIT 5 <br />TOTAL FEE 5 <br />PLAN CHEGK NUM9EN ��^” ""'-"" ""' <br />8A/13452 FEE 56. 23 AECEIPT NO. <br />FEES VALUAT�ON �FEE <br />eui�oinc <br />PLUMBING <br />�dECHANICAL <br />OTHER <br />PENALTY <br />TOTAL I � o$ � c <br />PERMIT VALIDATION <br />WMEN PROPERLY VALIDATED (IN THIS SPACE� THIS�IS"Y6U�! PEFp,1T <br />Setbacks on east and west sidesto be <br />10 feet and 20 feet on south front <br />yard with no £urther encroachment 3nto ;`�j <br />the nonconforming ei91rt ioot rear yard. � <br />�;��oi:e:s r��t <br />