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CITY OF <br />everett <br />1 CITY HALL 259 8745 <br />EVERETT, WA 98201 COMBINATION <br />UVIYJ1RUL 11(J:V C'(� EVCI <br />PERMIT <br />\ MIT <br />• BUILDING • MECHANICAL PLUMBING ,e <br />f <br />OWNER MAIL ADDRESS ZIP PHONE <br />David A. BRandvold P.O. Box 426, Mukilteo 355-1135 <br />m <br />z <br />c <br />�. m <br />m <br />C'. <br />ARCHITECT OR DESIGNER MAIL ADDRESS <br />Same as above <br />PHONE LICENSE NO. <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Same as owner BR-AN-DD-A-299QR <br />MECHANICAL CONTRACTOR MAIL ADDRESS PRONE LICENSE NO. <br />Evergreen State Sheet Metal (If required) <br />PLUMBING CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />Ray's Plumbing <br />PERMIT <br />❑COMBINATION <br />[RBUILDING []PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />VALUATION OF WORK <br />S 36,422.00 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK <br />Single family residence <br />PROPOSED USE <br />residence <br />MECHANICAL <br />TYPE OF ENERG V <br />❑GAS ❑LEC. <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT BLOCKIA-OF Victory Heicfhts <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />S 1 <br />REFRIGERATION UNITS-H.P. EA. <br />BOILERS-IRP. EA. <br />I <br />_ 1 <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />.TOR AnnPESS <br />430t Grand Ave. <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT HEATERS-B.T.U. <br />I <br />PLUMBING <br />_ <br />EVAPORATIVE COOLERS <br />l <br />CLOTHES DRYERS <br />I 00 <br />VENTILATION FAN <br />RANGEH000 <br />AInn <br />O. <br />TYPE OF FIXTURE OR ITEM <br />F E0 <br />_I <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />S <br />I <br />CLOTHES WASHER <br />I <br />WATER HEATER <br />DISH WASHERS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />DRINKING FOUNTAINS <br />I <br />FLOOR DRAINS <br />_ <br />GAS. SYSTEM: NO Or,TLETS <br />..11B TOTAL S <br />KITCHEN SINKS & DISP. <br />I <br />Ili 00 <br />BAR SINKS _ <br />- I <br />•'[RMIT 5 <br />ROOF DRAINS - RAIN LEADERS <br />1 <br />TOTAL FEE S <br />I <br />II <br />SHOWER BATHS <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS A <br />PRIVATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER ATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERF RMANCE OF CONS RUCTION. <br />x <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />_ <br />WATER CLOSETS <br />I <br />WATER HEATERS -ELECTRIC <br />I <br />WASH BASINS <br />4 On <br />LAUNDRY TRAYS <br />- <br />SUB TOTAL <br />2U ioz-- <br />PERMIT <br />TOTAL FEE <br />S �11 <br />0 -8 <br />WATER SERVICE SIZE BLDG. SUPPLY SIZE <br />SIGNATURE OF NTRACTOROR AV TH AGENT DATE <br />SIDE YARD SETBACK <br />61 <br />STREET SETBACK <br />201 <br />REAR YARDSETBACK <br />201 <br />PLAN CHECK NUMBER <br />77/610 <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />Basic <br />USE ZONE <br />R-1 <br />LOT AREA <br />VACANT SITE <br />30VES ❑NO <br />FEES <br />VALUATION <br />FEE <br />I <br />V <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO. <br />UNITS <br />OF DWELLING <br />l <br />I <br />BUILDING <br />S <br />1 <br />SIZE OF BLDG. <br />461 x 281 <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />PLUMBING <br />1 <br />FIRE ZONE <br />3 <br />BASEMENT FIRE5PRINKLERS <br />REQUIRED <br />Yes <br />yy,� <br />YES NO <br />[]YES <br />MECHANICAL <br />41 <br />SPECIAL CONDITIONS: <br />OTHER <br />PENALTY <br />SEC. 303(a) <br />I <br />1 <br />TOTAL <br />165' 00 <br />PERMIT VALIDATION Q� 2, @ t 0� Il Q <br />WIZEN PROPERLY VALIDATED TIN i. nCI1 F E I IT <br />_ YOUR RECEIPT <br />AWUCATIONACCEPIEB9Y: PLANS U14ECKED BY: AITROVTO FOR ISSUANCE BY. : THANK YOU <br />° 7R077 <br />Aul-)RtSS PILL <br />