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; <br /> n�',��������-i.� � <br /> e�����o,; CONSTRUCTIO"'�� <br /> PERMIT PERMIT NO. 12363 <br /> CITY HALL 259�87d5 <br /> r ���jW+��'s ❑ �6�lI�INATION � BUILDING C� MECHANICAL � PLUMBING <br /> OWNER MAILAODRE55 GITY ZIP PHONE <br /> Paul Forster 1125 Maple Everett 98201 252-6167 <br /> ARGMITEGT OR DESIGNER MAIL ApDPE55 CITV ZIP PRONE <br /> GENERAL CONTRACTOR IdAIL ADDRESS CITY 21P PNONE LICENSE� <br /> Same <br /> MECMANICAL WNTRFLTOR MAIL ADDRESS CI;V ZIP PHONE �ICENSE� <br /> PLUMBING CONTRACTOR M�IL AD�RESS GITY ZIP PHONE LICENSE� <br /> CLn55OF WOPK <br /> ❑ NEW EMADDITION O ALTERAiION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VAIUFTION OF WORN <br /> S Bi000.�0 <br /> DESCRIBE WORK ' <br /> Constract bedroom and wash room addition <br /> PROPOSED USE OF BUILDING �y <br /> Single Family Residence i HEtiEBY CERTIFY T�iAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE 1'RUE AND •• <br /> LEGRL�ESCRIPTIONOfPROPERTY�SNOWBELOWORATfACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �orl3-1�ocK 223F Everett Div GOVERNING THIS 1'YPE 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 y ,j <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE F � <br /> PERFORMANCE F CONSTRUCTION. y <br /> J09 FODRESS SIGNATU OR FI2ED AGEN7 DATE � <br /> 1125 Maple X ,...-- <br /> PLUMBING MECHANICAL y <br /> O <br /> NO. TYPE OF FI%TUHE OR ITEM FEE - N0. TYPE OF EOUIPMENT FEE � <br /> WATERCLOSET�TOILEn AIR COND.UNITS- M.P.EA. <br /> BATHTUB REFRIGERATION UNITS- H.P.EA. _ � �"� <br /> 2 <br /> LAVATORY(WASH BASIN) BOILERS- M.P. EA. � <br /> SMOWER GAS FIRED A.C.UNI75-TONNAGE EA. f.q <br /> KI�CHEN SINK 8 DISP. FORCED AIR SYSTEMS- B.T.U. M EA. HK N <br /> DISHWASHER WALL HEATERS- B.T.II. M Q � <br /> LAUNDRY THAY UNIT HEATERS- B.T.U. M � <br /> 1 CIOTHES WASMER EVAPORATIVE COOLERS <br /> WATER HEATER 1 CLO7HES DRYEHS 4 5 V1 <br /> URINAL VENTILATION FAN � <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT- C.F.M. <br /> VACUUM BREAKERS STOVE -WOOD • � <br /> ROOF ORAINS- RAINLEADERS METAL FIREPLACE d CHIMNEY <br /> SINN(SERVICE- BAR,ETC.) FIREPLAGE INSERT <br /> HEAT PUMP � <br /> � <br /> H <br /> SUB TOTAL f 4 0 O SUB TOTAL f 4 S 0 � <br /> _ PERMI7 S PERMIT f � <br /> TOTAL FEE f 4 00 TOTAL FEE f 4 S 0 py <br /> SIDE YARD SETBACK STREET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE � <br /> 5 ' 20' z� � 83/12363 FEE 44. 53 691R�r�iPTNO. <br /> USE ZONE LOT AREA VACANT SITE <br /> R-2 �. :YES X1Yp FEES VALUATION FEE <br /> TVPE OF CONST. OCCUPANCY GROUP NO.OF OWELLING UNITS <br /> V-N R-3 1 UUILDING S g�000. 6B 50 <br /> SIZE OF BLDG. NO.OF STOflIES MAY..OCC. LOAD <br /> Add' '1 LOO SQ. Ft. 1 PLUMBING 4 OO <br /> FIRF.ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED 4 � S O <br /> YES : <br /> APPROVALS BY DATE O7HER <br /> 1. ENVIRCNMENTAI.CNECK LIST PENALTY U.B.C. <br /> _ SEC.903(a) <br /> 2.BUILDING PLANS g <br /> 3.FIRE NYDRANi �i TOTAL <br /> 4.FIRE PROTECi�ON SYS PERMIT VALIDATION <br /> � �RA��" WNEN PROPEPLY VALIDATED(IN THIS SPACE)THIS IS YOUp[�P[ER(M�IT <br /> y.JRAINA9F . M I 4 3 5 � O � p. J u �' �.. <br /> �ZIENVIRO EI LIMPA TATEMENT <br /> � . t <br /> HEALT� T CT � <br /> PLIC�TI .BY 'j=PLANS CMECKED OY APPR.FOR ISSUANCE BY Y�.�U R R EC:E I PT ' ' <br /> � �; !•;�'�NK YOU <br /> � S �� a HWM LC <br /> �-i <br /> � AooRess ri�e ' 1 � S3 <br /> - _�. _- - - --_ _ � <br />