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r <br />Me <br />``P"TYO <br />CITY DFF ^ONSTRUCTION <br />everett PERMIT PERMIT NO. 1.3193 <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 [' COMBINATION BUILDING CX MECHANICAL kJ PLUMBING <br />OWNER MAIL ADDRESS CITY 21P PHONE +..1 <br />Duane Berg 2704 128th Street S.W. Everett 98204 252-6229 j <br />M A'� ADDRESS CITY ZIP PHONE LICENSE <br />GENERAL CONTRACTOR DU <br />Same _ <br />HELHANICAL CONTRACTOR <br />MAIL ADDRESS CITY 21P PHONE LICENSE <br />21P PHONE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL AODRESB LITV <br />GLASS OF WORKOPpy <br />NEW ❑ADDITION ❑ ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE El SIGN ❑ WOOD STOVEIFIREPLACE IN <br />SERT <br />VALUATION OF WORK <br />$ 52,000.00 <br />Construct Single gamily xesiaence <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Single Family Residence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR CTPIESI <br />LEGAL <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />28 valley View $II <br />LOT�BLOCK_OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CAN THE PROVISIONS OF ANY OTHER STATE OR <br />LOG LA REGULATING CONSTRUCTION OR THE <br />NMI U 8-28-5 <br />P ;FO AN'E OF CON UCTION. <br />NA E OF C TRACTOR CRI AG DATE <br />JOB ADDRESS <br />8019 Hamlet Lane <br />PLUMBING <br />MECHANICAL <br />PE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />OSET(TOILET) <br />4 QQ <br />AIR CON D, UNITS - H.P. EA. <br />2 <br />00 <br />REFRIGERATION UNITS - M.P. EA. <br />LAVATORY BASIN) <br />WKITCHENSINK <br />2 <br />OO <br />BOILERS - H.P. EA. <br />2 <br />00 <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />2 <br />QO <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />INK & DISP. <br />M <br />ER <br />2 <br />00 <br />WALL HEATERS - B.T.U. <br />UNIT HEATERS - B.T.U. M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />1 <br />CLOTHES WASHER <br />4 <br />S <br />1 <br />WATER HEATER <br />1 <br />CLCTHES DRYERS <br />2 <br />VENTILATION FAN <br />6 <br />00 <br />URINAL <br />DRINKING FOUNTAIN <br />1 <br />RANGE HOOD <br />AW HANDLING UNIT - C.F.M. <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />STOVE -WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR, ETC) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />S 20 <br />00 <br />SUB TOTAL $ <br />15 <br />PERMIT <br />S <br />PERMIT $ <br />f <br />TOTAL FEE $ 15 0 <br />TOTAL FEE <br />SIDE YARD SETBACK STREET SETBACK REAR <br />YARD SETBACK <br />PLAN CHECK FEE <br />PLAN CHECK NUMBER RECEIPT NO. <br />61 201 <br />20' <br />FEE <br />84/13193 183.75 68196 <br />USE ZONE <br />LOT AREA VACANT <br />SITE <br />FEES <br />VALUATION <br />FEE <br />R-1 <br />DYES []NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP NO. <br />OF DWELLING UNITS <br />BUILDING <br />$52,000.00 <br />289 <br />00 <br />V-N <br />R-3, M <br />1 <br />T4. Ft <br />NO. OF S1DRIES <br />MAX.. 005 LOAD <br />PLUMBING <br />20 <br />00 <br />-3SIZF3aF <br />MECHANICAL <br />15 <br />00 <br />M di7 Crt <br />FIRE ZONE <br />BASEMENT FIRE <br />REQUIRED SPRINKLERS <br />OTHER <br />U.B.C. <br />None <br />YES NO <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK_41ST <br />PENALTY <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL 324 00 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT O E LY VALIDATED ON THIS SRA E) THI( IT <br />SY <br />PERMIT VALIDATIONWHEWn , ��•� <br />�, <br />-S.RAOING <br />G <br />3 <br />r <br />Y,^ I p Cy: <br />) I ,' R I�EC f I r' <br />C <br />I_ C �'. F I <br />lAt�v 1'C: U <br />,(-DRAINAGE - <br />'T.ENVIRONMENTAL IMPACT STATEMENT <br />WHEALTH DISTRICT �.n <br />G\PPLICATION ACC. BY <br />-PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />EB <br />HWM <br />LC <br />I'. Y� U� <br />A <br />f� 2 Z AFI R 8 4 AFH S 4 <br />ADDRESS FILE <br />