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rlir Lberun�r,� <br /> �ON�TRUCTIO � " <br /> e�ere�h <br /> � �RIVi �� PERMITNO. '_ �' ' . '':; ?, <br /> CITY HFLL 259�57d5 <br /> ever�e�r.v�n sa�oi � COMBINATION �iU BUILDING �J MECHPr11CAL �J PLUMBING <br /> OWHcW NFiL4DDRE55 G'�Y LP PHONE <br /> Cujardin Develop:nent P.O. Box 5308 Everett :�8206 334-5018 _ <br /> ARGMREOi OR[�ESIGNEF �AAIL ADDRE55 CITV ZiP PHONE <br /> GEUERAL CONTRPGIOF MAIL qD�PE55 CITY Z�P PHONE LICENSE� <br /> Same _ <br /> MECIIANICALCONTRAGiOR MAILADOBti55 CITY ZIP PHCNE LIGENSE � <br /> PLUMBIIIG CGNTPACTOR fAAIL ApORE55 GItY ZIP PHONE IICENSE� <br /> CL.SS OF VJORK <br /> �NB^1 ❑ ADDITION ❑ ALTERATION ❑RtPAIfl ❑ DEMO�ITION ❑ FENCE ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br /> VnLUATION OF V/ORN <br /> s 63,000.00 <br /> DESCPI�E WORN <br /> Construct Single Family Residence <br /> VROPOSED USE OF BPiL�ING <br /> Single Fvr�ily REsidence I HERELY CERTIFY THAT I HAVE READ AND EXAA7INED THIS <br /> APPLICATION AND KNOW THE SAME TO B9 TftUE AND <br /> �ec4�oescRianoHOFaaor�ea�rISMOW6ELOYlORATiACMFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �cr 3 e�ocK_cr Intercity Park GOVERhING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHEfi SPECIFIED HEREIN OR NOT.THE GFANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE P.UTHORITY TO VIOLATE <br /> — OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> Z 13 28 4 LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFURpMkANCE OF CC� 7RUCTION. <br /> JOB aOUHESS EdSt 56 U�ONiHAC O OI ❑ NOPIZEflAGEf � OATE '/ <br /> k.�4+{�3[Xad}t�yi{Xi9�{MK7{ 121 Intercitv Aven e X —.��`"�Y <br /> PLUMBING MECHANIC _ <br /> NO. TYPE OF FIXTUFE OR ITEM � FEE NO. TYPE OF EOUIPMENT FEE <br /> 3 \NATE.ACLOSE��TOILE� G OG AIH CUND. UNRS - H.P. EA _ <br /> BATHTU6 � 6 OO REFRIGERATICN UNITS - H.P. EA. <br /> _� LAVATORY(WASH BASIN� _ � BOIL[RS- H.P. EA. <br /> SNOVJER GFS FIRED AA.UNITS -TONNAGE EA. <br /> KITCHEN SIIJK S OISP. FORCED AIF SVSTEMS- B.T.U. M EA. <br /> �_ DISHWASHER 2 OO WALI HEATERS- B.T.LL �d _ <br /> LAUNDRYTRAV UNIT HEATERS - B.T.U. PA <br /> CLOTHESN'ASHER EVAPORATNECOOLERS <br />�., 1 _}-1';A7ER HEA(Efi __ Z OO CLOTHES DRYERS � �. <br /> - � U�INAL VENTILATION PAN ( <br /> DRINKING �OUNTAIN RANGE HOOD <br /> FLOOR �HAIN AIR HANDLING UNIT- QF.M. <br /> VACUUM���GFKERS STOVE- WOO� <br /> ROOF ORAINS- HAINIEADERS METAL FIREPLACE 8 CHIA7NEY <br /> SINK(ScNVICE- BAF, °TCJ FIREPLACE INSERT H <br /> — -� '—'-- HEAi PUMP - <br /> -- --- c <br /> SGOTOTAL S Z6 OO SUBTOTAL 5 22 SO r�, <br /> 'ERMIT 5 PEPMIT t <br /> TOTALFEC 5 26 OO TOTALFEE f 22 SO �� �. <br /> '-0E�BlCM � STPEETSEiBACK REAR YPRD SETBACK PLAN CHECf HUIdBER PLAN CHECK FEE , <br /> ." � �� 2O' 2O� FEE RECEIPT N0. ._; <br /> U�E ZGNE LOT AREA VACANT SITE 83/12693 _ 209_30 661Q6 �_ , <br /> �-Z �}IS NO _ FEES VALUATION_ F`.E <br /> iYNE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS � <br /> V-N R-3 1 9UILDING �3,000. 322 00 . <br /> SIZE OF BLDG. .`10.OF STORIES MAX.OCC. l.OAD - <br /> 1.814 Sq_Ft.___ ]. (j _ P�UMBING 2( �� _ <br /> RHE ZOV[ BASEMENT FIRE SPHINKLERS �J,ECHANICAL 'ZZ SO - <br /> REOUIF-cR• <br /> yes . ves +�#�o <br /> APPPOVALS BY OATE OTMEfi _ <br /> 1. EtvVIRONMENTAL CHECK LIST PENALTV U B C. - <br /> — SEC.JL31a1 <br /> ?.BUILDINGPLANS _ 3]O SO ' <br /> 9.FIREHYDRANT TOTAL _ � <br /> 4.FIREPROTECTIONSYSTENP . PEHMITVAL�DATICN � ` � (� ' <br /> S.GRA7ING IVHEN PROPEFLY VALIDATED pN THIS�P/��E'�TMIS I�1�O1�(i2'F�dU — (`;�� <br /> '_ _ �'. <br /> 6.bRRINAGE - .- i r:'�' ��.�: <br /> — .i <br /> 7.ENl'IP,ON�dENTALIMPACTSTATEMENT � � r •j <br /> B.HEALSII DISTRICT � ' " �� •.� i <br /> APPUCATION ACC.ei PLANS CMECKED BY APPR. FOR ISSUANCE BY •.; `�� ' � <br /> �- oTC, � �[4h1 LC <br /> � I _ , . <br /> .,. r <br />