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ihe£vergreen � ��� J +o <br /> �„Y :F - �;ONSTRUCT�OI�'-. --- �, �_� :- �� <br /> �ve.rett PERMIT 'rERMIT �. 16Q��� c <br /> GTV HALL 259A7�5 �y _.� � ��'� <br /> EVEREIi,WA 9B2pt �j COMBINATICIN ❑ BUILDING ❑ MECHANICAL ❑ PLUMBIN(i r �. - ' <br /> ��ICHAIS AS50C. 1429 BROA��A4°oness EVERETT WA °iTY 98201 Z'�52-1168� P„�NE <br /> N <br /> �fICMITECTOR�E IGNEN MAILPCDRE55 CITY ZIV FHON� <br /> 6ENER�L CONTRAGTJN MAIL FOLRESS CITY ZIP PMONE LIGEN9E/ <br /> D. G. Brandvold 5307 - 139th Ave SE Snohomish WA 98290 568-9342 DCBRAC171CM <br /> MECN�NICAL CONTRACTOR MRI�FpURE55 QTY ZIP PMJNE LICENSE II <br /> PLUMBING COHTR�CTOR MAIL AOORE55 CITY 21P PHOHE LICENSE� <br /> CU55 OF WOHK <br /> C�NEN' ❑ ADDIiION ❑ AL7ERATION O REPAIR ❑ DEMOLITION ❑ FENCE O SIGN O WOOD STOVEIFIREPLACE INSERT <br /> V�LUATION OF NORK <br /> s 34,000.00 <br /> UESCRIBE WORK <br /> To build single family resid�nce <br /> PROPOSED USE OF BUILOINO <br /> Single family residence IHEREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEG�L�ESCRIPTION OF PqppENTY�SMOW BELOW ON ATTACM fOUR GOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT,�y.xOCK22CLOF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECI�IED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUAIE TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGU!ATING CONSTRUCTION OR THE <br /> PERF RMANCE OF CONSTRU TION. <br /> JOB ADDRES: SIGN U E OF GONiPACiOR T UTHO D AGENT � � <br /> 1110 Maple X � � <br /> PLUMSINO MEC ANICAL <br /> NO. 7YPE Or FIXTURE OR ITEM FEc NO. 7YPE OF EQUIPMENT FEE <br /> WATERCLOSE�(TOILEn 2 � AIR COND.UNlTS— H.P. EA. <br /> BA7HTUB 2 Q� REFPIGERATiDN UNI7S— H.P. EA. <br /> LAVATORY�WASH BASINI BOILERS -� H.P.EA. <br /> SHOWEP GA:'�FIP.ED A.C. l�N1T5—TOIINAGE EA. <br /> KITCHF.N SINK d DISP. z 0 FOIiCI:D AIR SY3TEM5— B.1.U. M EA. <br /> � OISMSYASHER 2 OQ WALL H[ATERS— B.T.U. M <br /> LAUNOR�TRAY U�iIT HEATEHS— B.T.U. M <br /> � CLOTNESWAShER 2 QQ EVAPORATIVECOOLERS <br /> WATER H[ATER 2 QD � I:�OTHES DRYERS 4 5O <br /> URINAL � OENTILATION FAN 3 <br /> _ ORINKING FOUNTAIN � RANGE HOOD f� 5O <br /> FLOOR DRAIN AIR IIANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF�RAINS— RFINLEADERS METAI FIREPLACE 8 CHIMNEY <br /> SINK fSERVICE— PAR,EfC.) FIREPLACF INSERT <br /> ----- HEAT PL d' <br /> SUBTOTAL i �t�. OO SUBTOTAL S �Z OD <br /> PEflM1T S PERMIT f <br /> TOTAL FEE S �Z OO 70TAL FEE S �Z OO <br /> SIDE YARD SETBACK STREETSETBACK qEAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> Yi 5' 20' 20' 86/16052 FE�I�3.75 838��CEIPT NO. <br /> US€ZQNE LOT 9fiXA,LG ,YESNT SNO FEES VALUATION FEE <br /> R 1 ��) I <br /> NPE OF CONS7. OCCUPANCY GROUP NO. OF DWELLING UNITS <br /> V-N R-3 � BUILDING s 34000. 211 00 <br /> SIZE OF BLDG. NO. OF STORIES MAX. OCC. LOAO <br /> 960 Sf � PLUMBING 1z Q� <br /> FIRE ZONE BASEMENT RIEOUSRED KLEFiS MECHANICAL �Z OO <br /> �.'VES ;;NO <br /> APPROVALS 9Y DATE �THER <br /> 1.ENVIRONMEN7AL CHF�G�(UST PENAL7Y SECC303(a) <br /> 2.BUI�OING PLANS N <br /> 3.FIREHYDRANT TOTAL 235 00 <br /> r.FIRE PFiOTECTION SYSTEM PERMIT VALIDATION <br /> � 5.GRADING � WHEN PROPERLV VALIDATED(IN THIS��l�C �THIS •y�0N P T ('� <br /> �L I �.�� — <br /> �B.DRAINAGE Addl plan check fee due�- 3.40 ' <br /> � 7.ENVIRONMENTALIMP,g�TSTATEMENT �'�' <br /> a B.HEALSHDSTYiIC7 .v �� <br /> ir � <br /> �APPLICA710N�ACC.BY— PL�NS CHECKED BY APPR. FOR ISSUANCE BY � •� �� r � � � � <br /> ,-. . . . , i �. � �.� <br /> m�n �_ � j ef l c <br /> _; <br />, ;�� _ <br /> �1 ......' c�� <br /> ADDRESS PILE <br /> n <br />