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�,„,�;e,����,�,; . C4. �STRUCTIO" <br />c?roF , <br />Q�G���� PERM�T PERMIT N0. �-26�9 <br />GTV HAIL 259�8745 <br />�y c�aEQr�'✓r�9}z� g� �fiM�INATION � BUILDING �J MECHANICAL CXI PLUMBING <br />OWNEP MAILPDORE55 CITY ZIP PMONE <br />Duane M. Berg 2709 126th Street S.W. Everett 98204 353-6229 <br />ARCHITECT OR OESIGNER MAIL AODRE55 LITV ZIP PMONE <br />GENERAL CONiNACTOR MAIL ADORE55 diY ZIP PHONE UCENSE r <br />Same <br />41EGHANICAL CONTRAGTOR MAIL ADDRESS CITY ZIP PNONE IICENSE � <br />PLUMBING CONTPACTOR MAIL AOORESS GITY ZIP PHONE IILENSE � <br />�CNEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />s 55,000.00 <br />ICRIBE YIORN <br />Construct Single Family Residence <br />Single Family Residence <br />LOT 26 BLOLN_OF <br />8107 H <br />PLUMBIN6 <br />� <br />� <br />TYPE OF FIXTURE OR <br />WATER CLOSE7 RUILET) <br />BATHTUB <br />LAVATORY (WASM BASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />1:91NA1 <br />DRINKING FOUNTAIN <br />FLCOR DRAIN <br />'ACUUM BREAKERS <br />i�OF DRAINS - RAINLEADERS <br />SINK �SERVICE - BAR, ETG.) <br />SUB TOTAL <br />PERMIT <br />TOTAI FEE <br />SIDE YARD SE7BACK STREET SETBAi <br />G'(E)-10'(W) 20' <br />USE ZONE LOT AtiEA <br />R-1 <br />TYPE OF GOHST. OCCUPANCY G <br />V-N � R-3 <br />SdE OF BLDG. N0. OF STORIE <br />1328 Sq. Ft. I <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3.FIREHYDRAN7 � <br />d. FIRE PROTECTION SYSTBM� <br />5. GRADING <br />6.DRAINAGP l <br />TH <br />0o STG � f'�� <br />lN O� <br />fTl <br />�_. -� <br />_, <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />IARACHFOURCGPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />iew #II 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 CANCEI HE PROVISIONS OF ANY OTHER STATE OR <br />LOC L W REGULATING CONSTRUCTION OR THE <br />U 8 28 5 PE��N OF CODIE.TRUCTION. <br />SIG ATUI�EOF NTRACTOFpfjvJ+�o�TED90FNT DATE <br />MECHANICAL <br />EE N0. TYPE OF E�UIPMENT <br />4 00 AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS - H.P. EA. <br />2 GAS FIRED A.C. UNITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />2 WALL HEATEFS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />2 00 EVAPORATIVE COOLERS <br />Z OQ ], CLOTHES DRYERS <br />1 VENTILATION FAN <br />], RANGE HOOD <br />AIR HANDLING UHIi - C.F.M, <br />STOVE - ':'^^� <br />METAL FIREPLACE d CHIMNFV <br />FIREPLACEINSERT <br />HEAI PUMP <br />� <br />S <br />S <br />IEAR YAR� SETOPCK <br />20' <br />'ACANT SITE <br />}4'i5 '�. � NO <br />10. OF DWELLING U� <br />1 <br />AA%.00C.LOAD <br />5 <br />9RE SPRINKLEfiS <br />7EOUIRED <br />YES NO <br />�LANS CHECKED BY APPR.PORIS: <br />o HWid LC <br />O <br />CJ <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />83/12669 IFEE 193.70 <br />FEES VALUATION <br />BUILDING SS � OOO <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY U.B.C. <br />SEG. 303 6 <br />f 12 �� <br />S <br />f <br />�HECK FEE <br />RECEIPT NO. <br />__6�539_ <br />FEE <br />298 00 <br />20 00 <br />12 0� <br />TOTAL 330 00 <br />PERMIT VALIDAiION <br />WHEN PROPERLY VALIDATEU (IN TH{5 SP�GE) THI�S�YQ}le P�WM�T � <br />7U J L70 U <br />i.o <br />N <br />, , ��,� � �"CEIP7.--� <br />BY � <br />- . ', ��.I .� �I lJ U <br />ADDRESS FILE <br />-�o�c 83 <br />0 <br />