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/0-l5- <br />`he <br />0141SISTRUCTION <br />everett <br />PERMIT PERMIT NO. <br />18966 <br />amwwwA59-88\o <br />❑ DEMOLITION ❑ COMBINATION <br />❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />Marjorie E. Leeson, Mary Pat <br />Fritts 11201 3rd Ave SE 1t 3A Everett, WA 98204 <br />347-8997 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />Ken Haroldsen P.O. Box 440 <br />Duvall, WA 98019 788-5827 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE LICENSE• <br />Marjorie E Leeson, Mary Pat <br />Fritts 11201 3rd Ave SE 3A Everett, WA 98204 <br />347-8997 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE LICENSE <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />LIASS OF WORK <br />@ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLIT!ON ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />f 200,000 <br />DESCRIBE WORK <br />New residence <br />HEATSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />single family residence <br />LOT 3 I -LOCK <br />7B ADDRESS <br />4931 Harbor Lane <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 <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONT RACTOR. AUTH9RIZ�yD /��6� ENT, OR OWNER ��ATE <br />A / ,1 Y' / O-f.I L-itVi� 1! L i cJ7t ��/ ( /�J <br />PLUMBING <br />MECH NI L <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />5 <br />WATER CLOSET (TOILET) <br />25 <br />00 <br />� C — A-HNDLG UNITS — HP. <br />3 <br />BATHTUB <br />15 <br />00 <br />REFRIGERATION UNITS — H P. EA <br />7 <br />LAVATORY (WASH BASIN) <br />35 <br />00 <br />BOILERS — B T U./H P. <br />2 <br />SHOWER <br />10 <br />00 <br />GAS FIRED A C. UNITS —B T.U. <br />1 <br />KITCHEN SINK & DISP. <br />5 <br />00 <br />FORCED AIR SYSTEMS -- B T.U. M EA. <br />1 <br />DISHWASHER <br />5 <br />00 <br />WALL HEATERS—B.T.U. M <br />1 <br />LAUNDRY TRAY <br />5 <br />QQ <br />UNIT HEATERS — B.T.U. M <br />2 <br />CLOTHES WASHER <br />10 <br />00 <br />EVAPORATIVE COOLERS <br />URINAL <br />2 <br />CLOTHES DRYERS <br />13 <br />00 <br />DRINKING FOUNTAIN <br />5 <br />VENTILATION FAN _ <br />22 <br />50 <br />FLOOR DRAIN <br />1 <br />RANGE HCJD <br />6 <br />_ <br />BACKFLOW PREVENTERS <br />_ <br />2 <br />WATER HEATER <br />ROOF DRAINS -- RAINLEADERS <br />_ <br />_ <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC) <br />2 <br />MEI AL FIREPLACE 8 CHIMNEY <br />60 <br />00 <br />FIREPLACE INSERT <br />' <br />1 <br />1 HEAT PUMP00 <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />f 110 <br />00 <br />SUBTOTAL _ <br />124 <br />00 <br />PERMIT <br />f — <br />— <br />PERMIT <br />— <br />— <br />TOTALFEE <br />f 110 <br />00 <br />ToTALFE15 <br />124 <br />00 <br />FRONT SETBACK <br />30' <br />REAR SETBACK SIDE <br />25' <br />SETBACK <br />252 7.5' <br />PLAN CHECK NUMBER <br />87/18966 <br />FEE <br />643.18 <br />RECEIPT NO. <br />93986 <br />USE ZONE <br />R-S <br />LOT AREA <br />VACANT SITE <br />rYES ❑NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$200,000 <br />989 <br />50 <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO OF DWELLING UNITS <br />1 <br />PLUMBING <br />110 <br />00 <br />SIZE OF BLDG <br />4238 <br />NO OF STORIES <br />111 <br />MAX OCC LOAD <br />NA <br />MECHANICAL <br />124 <br />00 <br />FIRE SPRINKLERS REQUIRED ❑ YES QT NO <br />INVESTIGATION FEE <br />Sec. 304(e) <br />STATE BUILDING SURCHARGE <br />3 <br />50 <br />STATE ENERGY SURCHARGE <br />15 <br />00 <br />APPLICATIONACC BY <br />SH <br />PLANS CHECKED BY <br />Be <br />APPR FOR ISSUANCE BY <br />L.C. <br />DRIVEWAY PERMIT <br />20 <br />00 <br />TOTAL <br />1262.00 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />CC) <br />QD <br />M <br />00 <br />r_ <br />