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ipc tcc��rern <br />��r,�. ^t�MSTRi��T'I�{� <br />��tl.�L�l. PGI"'o1V11� PERMI" �i'�. 1���5 <br />f,ITY HALL 255�d745 <br />eveaerr, ;v!, sszai �] COMBINATION � BUILDING �L MECHANICAL �X—] PLUMBING <br />IVINEF � 1dNLFD�RE35 CItY ZIP PMONE <br />David Fox 7202 7th ��� Wes Everett 98203 347-4867 <br />ABC�iREGt 04 DESIGNEP MNL ADL'RESS CIfY ZIP PHORE <br />GENERAL GONTRFGiOR MAIL AOJRESA GITY 21P PHONE LICEFSE I <br />Northland Homes Inc. 12637 t9oodinville Drive A'oodinville 96072 488-0565 <br />MECMANICAL CONiRAGTOH IdAIL AOORE55 CItY ZIP PHONE LICENSE x <br />. NORTHHI159CG <br />OILMBING CONiRAGiOR �dl.IL A�DHE55 GITY ZIP PHONE LiGENSE � <br />CLA55 OF WORN <br />�(JEW ❑ ADDITIO'�i ❑ 1LiE9ATION ❑ RC�AIR G DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />YALUFTION OF WORK <br />�iO��.Qv - _ <br />�onstruct Single Family ?:esidence <br />Single Family azsidence <br />zZ N,aple Hei.ghts <br />�pi_BLOCN__OF_ <br />Lot 3 of Short Plzt <br />JOB FO�HE55 h <br />1402 Madrona �nxe G�� <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATcRCLOSET�TO�LET� _ <br />Z BATHTUB <br />Q LAVATORY�WASH BASIN) _ <br />], �HOWER <br />j KITCHEN SINK & DISP. <br />1 OISH4VASHER <br />LAUNDRYTFAV <br />1 CLOTHES WASHER <br />1 WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FIOOR DRAIN <br />VACUUM BFEAKERS <br />ROOF!7RAINS RAINLEAOERS <br />SINK I�-RVICE - BAR, ETG) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />SETBACK STREET SETBACh <br />6� 20' <br />R-1 <br />V-N R-3, M <br />R- S>F�7F fiLQG. Ft. N0. OF STORIES <br />,iUJL S z <br />[.�- FidA C — <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST_ <br />2. BUILDMG PLANS <br />3. FIRE HYDRANT <br />4. FIRE PFOTEC�ION SYSTEM <br />5. GRAf1ING <br />6. DRAINAGE <br />7.ENVIRONMEN7ALIMPACTSTATEMENT <br />e. NEALTH DISiRICT <br />APPLICA710N ACC. BY PLANS CHE <br />ss Hwri <br />COPIES� <br />M 36 29 4 <br />FEE <br />8 00 <br />S 00 <br />__ 8 00 <br />2 I 00 <br />i o0 <br />2 �� <br />S <br />S <br />s 30 <br />q61R YARD SETBAi <br />20' <br />VACANT SITE <br />�.x'YE"_ . . NO <br />NO. 0�= DWELLING <br />1 <br />MAX.00Q LOAD <br />1� <br />FIRE SPF�NKLEFS <br />REOUIREL� <br />�YES ��«NO <br />AV i DA7E <br />FOR ISSUFNCE RY <br />LC <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF IAWS A� D ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED \A'ITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF /. <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR C,A�IQ�E� THE PROVISIONS OF ANY OTHER STATE OR <br />L9G�AL LAI�J REGULATING CONSTRUCTION OR THE <br />PERFORMA�OCE OF,CpO�JSTRU T <br />�GNq�UREOF,LONT?ACdF'R IiAUI. / DATE <br />i <br />i� l /��%T � <br />NQ. � TYPE OF E�UIPMENT <br />AIR CGND. UNITS - H.P. EA. <br />REFRIGERATION UNITS - H.P. EA. <br />BOILEFS - H.P. EA. <br />GAS FIRED A.C. U�:ITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. �d E,1. <br />WALL HEATERS - B.7.U. M <br />UNIiHEATFRS-B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTh�ES D9VERS <br />VENTILATION FAN <br />PANGENO00 <br />AIR HANDU4G UNIT - QF.P7. <br />STOVE - WOOD <br />METAL FIREPLACE & CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUBTOTAL SI 30 OU <br />PEFMIT S <br />TOTAL FEE 5 3O OO <br />�N CH[CK NUh1BER v�ni+ ene�n re� <br />FEE RECEIPT NO. <br />85/19545 261.95 �S85a <br />FEES VALUATION FEE <br />BUILDING 8C�,000. 403 �� <br />PLl?dBING ;i� �� <br />�dEGHANICAL 30 OO <br />0T4FR <br />PLNALTI' U.B.C. <br />SEC.9031a) _ <br />TOTAL 463 00 <br />PERMIT VALIDATION .-, <br />WHEN PflOPERLY VALIOATHD'QN THIS SPACEI THI$ I$ YOUR PFFiM1T . <br />. �. . , . . . _ _ _' 'c'.i• <br />u� <br />'C7 <br />s'i <br />Ai�DR[5; FI!:: <br />z <br />0 <br />-� <br />,-~� <br />m <br />.. .-. <br />-{ '�i <br />,.. .� <br />(n 2 <br />0 <br />m <br />C O <br />mo <br />c� <br />O 3 <br />� <br />-i Z <br />m~ <br />o � <br />r " <br />� �, <br />-i �' <br />� <br />O �' <br />�l A <br />-� fT� <br />2 <br />m� <br />V <br />O <br />or <br />c� rr, <br />C (/ <br />3 v <br />fTl <br />z r. <br />-� r <br />- m <br />a <br />� <br />