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IN <br />theE%,eg�een <br />- ';ONSTRUCTICIP' <br />everett <br />PERMIT <br />PERMIT NO. 13172 <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />® COMBINATION G BUILDING Ri MECHANICAL <br />Gc7 PLUMBING <br />MAIL ADDRESS GItY <br />ZIP <br />PHONE' <br />OWNER <br />i <br />2704 128th Street Everett <br />98204ZP <br />353-6229 <br />Duane Berg <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />DU AN <br />EM B224DA <br />Same <br />CITY <br />21P <br />PHONE LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE 0 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />t. <br />FXNEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN O WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />S 55,000.00 <br />Construct Single Family Residence <br />Single Family Residence <br />LOT 33 <br />JOB ADDRESS <br />8011 Hamlet Lane <br />Valley View #2 <br />U 8 28 5 <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 LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANC E PROVISIONS OF ANY OTHER S'fATE OR <br />LOCA AW R GULATING CONSTRUCTION OR THE <br />OR <br />DATE <br />PLUMBING <br />- -- <br />NO. <br />TYPE OF EQUIPMENT <br />F <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR UNITS H.P. EA. <br />WATER CLOSETITOILET) <br />W <br />2 <br />00 <br />RIDERCOND <br />N <br />REFRIGERATION UNITS - H.P. EA. <br />_ <br />1 <br />BATHTUB <br />4 <br />00 <br />BOILERS - H.P. EA. <br />2 <br />LAVATORY (WASH BASIN) <br />2 <br />00 <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />1 <br />SHOWER <br />2 <br />00 <br />FORCED AIR SYSTEMS - B T.U. M EA. <br />1 <br />KITCHEN SINK & DISP. <br />00 <br />WALL HEATERS - B.T.U. M <br />1 <br />DISHWASHER <br />2 <br />UNIT HEATERS - B.T.U. M <br />LAUNDRYTRAY <br />2 <br />00 <br />EVAPORATIVE COOLERS <br />1 <br />CLOTHESWASHER <br />2 <br />00 <br />CLOTHES DRYERS <br />1 <br />WATER HEATER <br />URINAL <br />VENTILATION FAN <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />STOVE FI WOOD <br />VACUUM BREAKERS <br />METAL FIREPLACE 8 CHIMNEY <br />ROOF DRAINS - RAINLEADERS <br />SINK (SERVICE - BAR. ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />+ 20 00 <br />SUB TOTAL <br />f <br />PERMIT <br />f <br />PERMIT <br />f <br />20 00 <br />TOTAL FEE <br />f 15 00 <br />TOTAL FEE <br />STREET SETBACK REAR <br />f <br />YARD SETBACK <br />^LAN CHECK NUMBER PLAN CHECK FEE <br />S1DE YARD SETBACK <br />2p' <br />20' <br />84/13172 FEE193.70 <br />RECEIPT NO. <br />68189 <br />61 <br />SITE <br />FEES VALUATION <br />FEE <br />USE ZONE <br />LOT AREA VACANT <br />R-1 <br />MS NO <br />OF DWELLING UNITS <br />— <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO, <br />V-N <br />R3, - M <br />1 <br />BUILDING f 55,000. <br />298 00 <br />O BLDG. <br />NO. OF STORIES <br />MAX.00C LOAD <br />PLUMBING <br />20 00 <br />R3-Sffi Sq. Ft. <br />1 <br />6 <br />M 520 S . Ft. <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLER`, <br />MECHANICAL <br />15 00 <br />REOUIRk <br />0 <br />YES <br />BY DATE <br />OTHER <br />U.B.C. <br />APPROVALS <br />I. ENVIRONMENTAL CHECK_ LIST <br />PENALTY SEC. 303 (a) <br />TOTAL <br />333 00 <br />2. BUILDING PLANS <br />3, FIRE HYDRANT <br />4, FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION W <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) <br />C- <br />THIS Yf�� P�F�g17 h' <br />S. GRADING <br />....I <br />0ll n n ll _ 3 <br />2 ll <br />DRAINAGE - <br />. <br />�6 <br />_7.ENVIRONMENTAL IMPACT STATEMENI <br />�Y <br />�J f` RECEIPT <br />A; HEALTH DISTRICT _n <br />APPLICATION ACC. BY, SLANS CHECKED By <br />APPR. FOR ISSUANCE BY <br />I (. <br />T !-i ^NK YC U <br />_ <br />i EB -� HWM <br />LC <br />I) <br />ADD6E1S"pIiE U i, <br />2 APR 8 4 <br />