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dic£rrr�;rrrn � `,CONSTRUCTIO� • <br />c�Tvor � pERMIT PERMIT NO. 152H9 <br />everett <br />CITY HALL 259�8745 <br />EVERETT, WA 98201 � COMBINATION I� BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNCR MAIL AOORE55 CITV ZIP PHONE <br />Dennis Koger 1341 Mukilteo Blvd. Everett 98203 252-7858 <br />AFCHITECT OR DESIGNER MAIL ADORESS CIT� ZIP PHONE <br />GENERALCONTRAGiOR MAILAODRESS CITY ZIP PMONE LICENSE� <br />Same <br />MECMANICAL CONTRAGTOR MAIL AOORESS CITY ZIP PHONE UCENSE � <br />PLUMBING CONTRACTOR MAII AUDRE55 pTY ZIP PMONE UCENSE II <br />y���� V, • v^^ ❑ NEW �%ADDI710N O ALTERATION ❑ REPA�R O OEMOLITION ❑ FENCE ❑ SIGN O WOOD STOVEIFIREPLACE INSER7 <br />VALUATION OF WORK <br />S 10�0��.�� <br />Addition to existing residence <br />ise aF em�omu <br />Family Residence <br />LOT?3 BLOCK_OF <br />JOB AD�RE55 <br />1341 Mukilteo Hlvd. <br />PLUMBING <br />OF FIXTURE OR <br />BATHTUB <br />Z LAVATORYIWASH BASIN) <br />1 SHOWER <br />1 KITCHENSINK801SP. <br />1 DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREnKERS <br />ROOF ORAINS — RAINLEADERS <br />SINK (SERVICE — BAR, E7C.) <br />� <br />R-1 <br />V-N <br />SIZE OF BLDG. <br />12'x30' Add'n <br />1.ENVIRONMENTAL <br />2. BUILDING PLANS <br />J. FIRE HYDRANT <br />4. FIFE PROTEC710N <br />�F. GRADING <br />6�DRAINAGE - <br />A ENVI RONMGNTAL <br />9! HEALTH DISTRICT <br />SUB TOTAL S ].4 0 <br />PERMIT S <br />TOTAL FEE S <br />AEET SETN/�K REAR YARN�A BACK <br />IT AREA VACANT SITE <br />20,700 Sq. Ft. ; vE5 XXiO <br />R-3 <br />NO. OF STORI <br />2 <br />BASEMENT <br />yes <br />APPROVALS <br />�HEC�C�IST <br />� <br />ON 4CC. BY <br />` �. <br />BY <br />JEF <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 CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIG E OF CONTFACTOR OR AU7HORI U AGENT DATE <br />X � � �� <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNI7S — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNI7S — TONNAGE EA. <br />� ORCED AIR SYSTEMS — B.T.U. M EA. <br />W,�LI HEATERS — B.T.U. M <br />UNI'i HEATEFS — B.T.U. M <br />EVAPURATNE COOLERS <br />CLOTHES DPYERS <br />3 VENTILA710N FAN <br />RANGE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — V�'OOD <br />METAL FIREPLACE 8 CHIMNEY _ <br />FIREPLACEINSERT <br />HEAT PUfdP _ <br />sue 707AL s g <br />PEHMIT S <br />TOTAI FEE t 9 <br />FEE FECEIPT NO. <br />15289 52 33 L 79271 <br />FEES VALUATION I FEE <br />1 BUILDING 510,000. 80 SO <br />A%.00C.LOAD <br />N/A PLUMBING 14 00 <br />I7ESPRINKLERS MECNANICAL 9 00 <br />EaUIRED <br />YES O <br />BY DATE OTHER <br />PENALTY U.B.C. <br />SEC. 303 (a) <br />TOTAI 103 50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIOATED (IN TH4SiSR.AGE) THI�I^�Yfal}�•P�F�AIT � <br />J 4/ Ul)U U <br />3 , �OI��.QO— 3 cv <br />Ln <br />�PPR. POR ISSUANCE BY YO U n R�� � E 1 PT �� <br />'��: R�CCIPi 'i!',1��i: 1'OU <br />� <br />�'. 1'�!J � <br />� - '' �C( d� <br />ADDRE�i 6'1� j� j <br />