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�`�He�Ereigre:n �+� N�T R U CT ��� � <br />ev'er�tt IS • PERMIT PEFiMIT i�0. �37g1 <br />CITY HALL 259�A745 <br />t7 eve�e�r,liv�,�y�zci ;� QpMBINATION � BUILDING � MECHANICpL � PLUM3INC <br />OWNEP MAILADORESS CITY ZIP PHONE <br />Richarz G. Miller 6202 West Magnolia Everett 98203 355-•6412 <br />ARGHITEGTORDESIGNER MAILADORESS CITY ZIP VHONE <br />GENERAL CONTRACTOP IAAIL ADDRESS CITY ZIP PMONE LICENSE A'� <br />Same <br />MEGMANICAL CONTqAGTOR IAAIL ADORESS GITY ZIP PMON2 LIGE'JSE I <br />PWMBING CONTRACTOR MAIL AOOflE55 CITY ZI� PHONE LICENSE � <br />❑ NEW '�ADDITION ❑ AL7ERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCc ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S 10,000.00 <br />DESGRI6F WOF'S <br />Construct bedroom and bath <br />Single Family Residence <br />103 Westwood <br />LOT _ BLOCN _OF <br />V � NUU11 W � <br />G202 West Maqnolia <br />PLUMBING <br />NO. — TYPE OF FIXTURE OR <br />1 WA�ERCLOSET�TOILEn <br />BATHTl1B <br />SHOWEFi <br />KITCHEN SINK 8 DISP. <br />'4UNDRYTRAV <br />�LO7HES WASHER <br />WA7ER HEA7ER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />pOOF DRAINS — RAINLEAOERS <br />SINK (SERVICE — BAR, ETC.) <br />S' <br />!ONE <br />R-2 <br />OF CONST. <br />V-N <br />oF e�oc. - <br />480 Sq. Ft <br />TOTAL FEE <br />EET SETBACK <br />20' <br />AREA <br />;UPANCY (iROUP <br />Add'n R-3 <br />OF STORIE� <br />1 <br />I None <br />APPpOVALS '-- <br />1. ENVIRONMENTAL CMECK LIST <br />2. BUIL�ING PLANS �^ <br />7.fIREHYDRANT <br />4. FIRE PROTECTION SYSI EM <br />5. GRADING <br />�--6. DRA'NAGE <br />"6-1.ENVIRONMENTALIMPAGT$TATEMENT <br />I-8. HEAL7H DISTRICT -- <br />" APPLICATION ACC. BY <br />o.. <br />_ S� , , <br />. -- <br />' HWM <br />� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND K�IOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVIuIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE C9ANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORiTY TO VIOLATE <br />OR CANCEL TH PROVtSIONS OF ANY OTHEP. STATE OR <br />LOCi\L LAW�EGULATING CO� TRUCTION OR THE <br />PERF � OF CONSTRUCTI010. <br />cir. a nc u nr..nRY�G nin�f[�aizFo.ifI�NT OATE <br />FEE NJ. TYPE OF E�UIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNI�S — H.P. EA. <br />2 Q� BOIIEFlS — Ii.P. EA. <br />2 Q� GAS FIRED A.G. UNITS — TONNAGE EA. <br />2 FORCED AIR SVSTEMS — B.T.U. M EA. <br />2 �Q WALL HEATERS — B.T.U. M <br />,�NIT HEATERS — B.T.U. M <br />EVAPORA7IVE COOLERS <br />CLOTHES DRYERS <br />1 VENTILATION FAN � <br />i7ANGE HOOD <br />AiR HANDLING UNIT — C.F.M. <br />STOVc —'::C :D <br />METAL FIREPLACE 8 CHIMNEV <br />FIPEPLACEINSEFT <br />s 10 <br />S <br />5 10 <br />flEAR VAPD SE70A1 <br />20' <br />VACANT SITE <br />L]VES L:NO <br />NO. OF DWELLING <br />1 <br />rnnx. occ. �_ono <br />N/A <br />FIRE SPRINKLEFS <br />REQUIRf,� <br />[ YES %IO <br />BY DA7E <br />FOR ISSUANCE BY <br />LC <br />SUBTOTAL S <br />PERMIT S <br />TO7AL FEE 5 <br />84�13791 I FEE 44.53 I RECEIPT NO. <br />FEES VALUA7ION �� §�E <br />BUILDING � lO,U00. 80 SO <br />PLUMBING LO OO <br />MEGHANICAL 3 OO <br />OTHER <br />PENALTY U.B.C. <br />SEC. 303 (a) <br />rorn� 93 50 <br />L <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDA7ED (IN iHIS SPACE) THIS IS YOUR PERMIT 1--� <br />� � �- �� � �_�� J �. �.' � __ � <br />ADDRESS �ILE <br />� <br />M <br />_ � <br />iI <br />. i :I <br />'; ,.��..� �, � <br />