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1he L'�rrgreen _ s � ����� ��'� � , <br /> !� <br /> c�rv �r � � <br /> ������� ���� ,� PERMIT NO. �.�� `'� <br /> CITY HALL 2`v9�Pia5 <br /> evEaErT.wti eazoi �] COMBINATION � BUILDING � MECHANICAL � PLUMBING <br /> o�r+r�Ea rnni�aooaess cirr ziv ��her:E <br /> Dujardin Development P.O. Box 5308 Everett 98206 334-5018 <br /> ARGHITEGT OF DESIGNER IAP��_ADDRE55 CITY ZIP PHONE <br /> GEI1ERfL GONiqAGiOR MAIL AJDRE55 GITY 2iP PMONE LICENSE M <br /> Same DUJARDC211RL <br /> IAECHANICAL CONiPPCTOR MAIL ApDFE55 CITV ZIP PHONE LILENSE+ <br /> PWMBING LONiPACTOF MP4 ADDRE55 CITY ZIP PXONE LICENSE N <br /> CLFSS OF 1'/ORK <br /> �}CNEYJ ❑ ADDRION ❑ ALTERATION ❑REPAIR � GEMOLITION ❑ FENCE ❑ SIGN ❑ W000 STOVE/FIREPLACE INSERT <br /> VALUATION C�YlORK <br /> s 40,320.00 <br /> �ESCFIAF KURN <br /> Construct Single L'ami.ij R�sic._nce <br /> .:�o�oseo use or ew�owc <br /> Single Family REsidence I HEREBY�FRTIFY THAT I HAVE READ AND EXAtv1!NED THIS <br /> APPLICATIO;J AND KNOW THE SAME TG BE TRUE AND <br /> Le4nLDESCRiPTIONOFPROPERiY�SHu.YBELOWORATTACHFOURCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or n e�ocK_oF Intercity Park GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT?RESUME TO GIVE�UTHORITY 70 VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPT[ OR <br /> Z 13 28 4 LnCAL LAW REGULATING CONSTRUCTION UR THF <br /> _ PERFORMANCE OF CONSTRUCTION. <br /> J00 AD�P[55 EdSt SI�N IIR OF CONTR ' H O iHOR12E0'AG[N OATL <br /> ��������� 119 7atPrcity Avenue X � , .j� ,�G, ,4.� �� <br /> PWtdBING MECHANIC <br /> N0. TYPE pF fIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FFE _ <br /> _ z W.OTERCLOSET�:OILETI Q� AIR CONG. UNITS— H.P. E0. _ <br /> 1 �ATHTUB ? ��� REFflIGERATICN UNITS— H.P. EA � __ <br /> � LAVATORY(WASH BASIN� n �;) BOILERS— H.P. EA. � <br /> SHOWER GAS FIR[�P..C. UNITS —TONNAGE EA. <br /> ], KITCHEN SINK d DiSP. Z p� FORCED AiN SYSTEMS— 7.T.U. M cA. <br /> 1 D�SHWASHfF 2 �� VrALL hEATERS— B.T.U. M <br /> LAUIaDRY TFAV UNIT MEATC:RS— B.T.U. M <br /> ]. CLOTHES W4SHER Z u� EVAPORATIVE COOLERS <br /> _' _ —�— <br /> 1 WATER MEATER 2 OO ], CLOTH� S DRYERS 4 � SO <br /> _ UFINAL 2 VENTILATION FAN _ ( OO � <br /> DRINKING FGUNTAIN 1 RANGE HOOD �'I SO r�". <br /> FLOOR DRAIN AIR HANDLING UNI7 — C.F.M. r <br /> T <br /> VF^�UUM BREAKERS STOVE —VJOOD � ' <br /> RGOF ORAINS— RAVILEADERS 1 METAI FIREPLACE 8 CMIMNEI' � 50 <br /> SINK�SERVICE— BAR,ETQ) FIflEPLACE RISERT <br /> I1ENT PUMP <br /> H h- <br /> y ,: <br /> H � <br /> U � <br /> SUB TOTAL + ],B OO Sl1B TOTAL f 22 SO � <br /> PERMIT S ___ PERMVT 5 M � <br /> TOTAL P[E S �.H 00 ���� TOTAL FEE S 22 SO � �_ <br /> YDFVAFD SFTgqCK STREETSETBACR REAR YAftD SE7'BACK FLAN CHECK NUMBER PLAN CHECK FEE �� <br /> S' 20' 20' 83/12694 FEI57.63 aeceivT rao. <br /> 66106 = ,_ <br /> uS[ZONE LOT ARLA VACANT SITE --- <br /> R—Z XWES � NO FEES VALUATION FEE __ � % <br /> 7Y'Pi:OF CONST. OCCUPANi.f GHCUP N0. OF DWELLING UNITS � �� <br /> V-N R-3 1 pUILDING s 40,320. 242 50 '� .�� <br /> SIZF OF BLDG. NC.OF STOFIES MA%.OCC. LOAO - � <br /> ILS2 S . Ft. 1 4 PLUMBING ],8 QO 'T1 r: <br /> FIRE ZONE 9ASEPdENT FIRE SPOINKLERS C' <br /> REOUIFEO MECHANICAL 22 �� � , � <br /> Yes . ves o - - <br /> eTHEa � <br /> APPROVAI.S BY OATE 8 �-: <br /> 1. ENVIRONMENTAL CHECK LIST U B.C. � <br /> PENALTI' SEC.90i13) �% �. <br /> 28UILDINGPLANS �� - <br /> 3.FIRF.HVDRANT TOTAL 2$3 OO � ; <br /> a.PIRE PROTECTION S�S�EM—' PEflMIT VALIOATION � <br /> 5.GRADING WHEN PROPERLY VALIDATED pN TNIS SPACE)TH15,IS VOUfi PERMIT � <br /> C � � � � '] C ' _ .3. <br /> G.DRAINPGE . !.": c i " ^ i 'I Q . ' . ._ ': L. .: '. �.�i <br /> 7.�ENVIRCNMENTALIMPACTSTAT[MENT ' I "' �� �' — � � <br /> , N <br /> 9.N61LTH DISTRIGT � :_ <br /> AP'r�ICATION ACC. RY • PL!"5 CHECKFD BY APPR. FOR ISSUANCE BY �. � (_'.� C I PT :_ <br /> �n � ��� . . ; ���J U rr <br /> � -� STG � � I�� = fiWDf LC <br /> I � � �� <br /> .`,i;!lciJi_. (i;.': , . <br /> � <br />