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!hr L�rerxrcc�t � p N ST R U�T I O P�' <br />crtvoF �- <br />everett PEF�MIT PERMIT NO. 1393 ( <br />GTY HAL1259-d7d5 <br />EVERETT,VJA98201 0 COMeINATION Ix�• BUILDING ❑ N;ECHANICAL ❑ PLUMBING _ <br />MaIL /.��RESS <br />CITY 2P PMONE <br />01YNER <br />E Lyle Miller 2517 Slst S.W. Everett _98203 355-481 <br />ARCMITECi OF OESIGHEi� MAIL A�DRE55 <br />LrtY 21P PMONE <br />GF.NERALfpNTP4CTON <br />MAILAD�RE55 CITY ZIP rn•^•� -'---- <br />SLI�e CITY IIP PH�NE LICENSE+ <br />h1EGNANICAL GONTPACTOR IAAIL A�OFE55 <br />PLUMOING GONTRAGTOR MAIL AOORE55 <br />GIiY ZIP MMONE UCENSE � <br />GLA55 OF WORh <br />❑ NEW 7� .4D�ITION ❑ AUERA710N ❑ REPAIR ❑ DEMOU710N ❑ FENCE ❑ SIGN ❑ WOOD STOVEIP�REPLnCE INSE <br />VAlUA710N OF \VO�K <br />° ].6,000.00 <br />DESCP19C VlOPe <br />Add 204 Sq. Ft. Addition to exisling reside <br />single family residence <br />io4'? BLOCK 6 aF <br />200G Mukilteo Blvd. <br />PLUMBING <br />NO. TYPE OF <br />1 WATERCLOSET�T <br />l BATHTUB <br />LAVATOflY�WASHBA: <br />SHOWER <br />KITCHEN SINK & DISP. <br />DISHWASHER <br />LAl1NDRY TRAY <br />CLOTHE51'IASHER <br />WATER NEATER <br />OR <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETQ) <br />V-N <br />6LDG. <br />Sq. Ft <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />REET SETBAC <br />IT AREA <br />]CUPANCY Gi <br />Addn-R-3 <br />J. OF STORIE'� <br />� 1 <br />7. ENVIRONMENTPL CHECK LIST <br />2. BUILDING PLANS ' � <br />J.FIREHV�RANT . <br />4. FIRE PqOTECTION SYSTEM- <br />5. GRADING <br />O.ORAINAGE <br />7.ENVIRONMENiALIMPACTSTATEMENT <br />5 1� 0� <br />5 <br />5 10 00 <br />REAR YARD SETBACK <br />VACANT SITE <br />�..YES .-.NO <br />NO. OF DWELLING UNI <br />1 <br />MAR.00C.LOAD <br />N/A <br />FIRE SPRINKLERS <br />REOUIRED <br />i YES O <br />I BY DATE <br />'B.HEALTMDISTRICT -"- <br />�APPLICATION'ACC. BY '. PLANS CHECNED BV APPR. FOF <br />� E$ x�ari z.c <br />� <br />-, <br />, <br />I HERE6Y CERTIFY TFiAT 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 WOFiK WILL BE COMPLIED WITH <br />ERMIT OFSN TIPR SUMETOGIV�A THORITYTOVO�TE <br />L�OCALN LAW HREGU�LAITINGSCONSTRUOCTTION SORT TH�E <br />PERFORMANCE OF CONSTRUCTION. qpiE /�/ <br /><�r.uevttl�(]� COdPRACTOR 09 AUTHOR2ED AGENT <br />MECHANICAL <br />TYPE OF E�UIPMENi <br />AiR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILLRS — H.P. EA. <br />GAS FIRED A.C. UNIT� — tONNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEA7ERS — B T.U. M <br />EVAPORATIVE COOLEHS <br />CLOTHES �RYERS <br />VENTILATION FA� <br />RANGEHOOD <br />AIR HANDLING UNIT — C.P.M. <br />STOVE -- WOOD <br />METFL FIREPLACE 8 CHIMNEY <br />fIREPLACEINS£RT <br />HEAT PUMP <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />2C, c <br />�J / �� F Ef' %3 <br />FEES VALUATION <br />BUILDING <br />PLUAIBING <br />MECHANICAL <br />OTHER <br />Fj <br />S <br />S <br />S <br />FEE <br />FEE <br />PENAL7Y SEC. 303 (al <br />126 50 <br />iOTAL <br />PERMIT VALIOATION - <br />WHEN PROPERLY VALI�ATED ��N TH�S SPAiE) THIS IS,YQU�i P,EFMIT •.-; <br />� l . . <br />BY <br />ADURESS PILE <br />�� r <br />'� ^ i : � � � <br />H 1- <br />� � <br />H r= <br />0 �: <br />t� � <br />GF <br />x � <br />n <br />�!. <br />��. <br />ri � <br />� � <br />O� <br />� �. <br />r <br />� '" <br />�,. <br />