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rhP l.rPrCrCCn <br />��„� ��� <br />everett <br />CITV HALL 259�0745 <br />� �ONSTRUCTIOR' <br />PERMIT PERMIT NO. l��l`Tl <br />EVERETT, WA 98207 � COMBINATION CX BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAILA�ORE55 GIiY ZIP PHONE <br />Heulah Knufman 2220 McDougall Everett 98201 259-2238 <br />ARGHITEGT OR DESIGNER MAII AD�RE55 CRY Z�P PMONE <br />GENEPNL CONTRAGTOR MAIL AD�RE55 CITY ZiP PHONE LICENSE Y <br />Three Lakes Construction 6523 171 Avenue S.E. Snohomish 98290 252-2173 <br />MECHPNICAL CONTRAGTOR MAIL ADORESS CITV ZIP PNONE LIGENSE x <br />THREELC201PY �t <br />PLUMBING GONTRFGTOR MAIL AD�RE55 GITY ZIP PMDNE LICENSE x <br />❑ NEW ❑ ADDI710N D ALiERA710N �}FiEPA1R ❑ DEMOLITION ❑ FENCE O SIGN O WOOD STOVEIFIREPLACE INSERT <br />S 600.00 <br />�ESCRIp'c WORN <br />Repair siding and skir <br />ROPOSED USE OF BWLOING <br />single family residence <br />EG/l UESCRIPTION OF PROPERiV �SMOW �E <br />�oi 23-z���cK 474oF <br />1013 ADDRE55 <br />2220 McDougall <br />PLUMBING <br />NO. TYPE OF FIXTURE OI <br />\NATER CLOSET (TOILEn <br />BATHTUB <br />SIDE <br />SHOWEfl <br />KITCHEN SINK R DISP. <br />DISHINASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEA7ER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS - RAINLEADERS <br />SINK (SERVICE - BAR, ETQI <br />SUB TOTAL <br />PERMIT <br />TOT L FEE <br />LOT AREA <br />NO.OF <br />1. EN\9RONMENTAL CHECK LIST <br />2. 6UIL�ING PLANS <br />3. FIRE NYDRANT <br />4. FIFE PROTLCTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />B.HEALTN DISTRICT <br />nPPLICATION ACC. BV PLANS CHECKED BV <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 />S�OFCOq(RACTORO'/�l�`H/ IZEDAGENT /,/ �DAT�(/ <br />L C / <br />MECHANICAL <br />FEE N0. TYPE OF EOUIPMENT FEE <br />41R COND. UNlia - H.P. EA. <br />FtFRIGERATION UNITS -- H.P. EA. <br />BOILERS - H.P. EA. <br />GAS FIRED A.C. UNITS - iONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />WALL HEATERS - B,T.U. M <br />UNIT HEATERS - B.1.U. M <br />EVAPORAtIVE COOLERS <br />CLOTHES DRVERS <br />VENTILAiION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />METAL FIREPLACE 6 CHIMNEV <br />PIREPLACE WSERT <br />HEAT PUMP <br />� <br />S <br />f <br />EAR vAFD SE7B< <br />ACANT SITE <br />YE$ NO <br />IO. OP DWELUNG <br />7AX.00G LOAD <br />IflE SPRINKLERS <br />BV I DATE <br />SUB 70TAL S <br />PEPMIT 5 <br />TOTAL FEE E <br />PLAN CHECK FEE <br />PE[ I RECEIPT NO. <br />FEES I ���UATION � FEE <br />BUILDING 5 600.00 11 50 <br />PLUMBING <br />MECMANICAL <br />OTHER <br />_ PENALTY SEC 303 (a) <br />TOTAL 11 5� <br />PEPMIT VALIDATION <br />WHEN PROPERLY VALIDFTEU pN THIS SPACE) THIS IS YWR P8Rh11T___ � <br />i i � <br />�"9 <br />� <br />I, IY ] <br />i'Y <br />z <br />0 <br />—� <br />c� <br />m <br />--1 T <br />Vt 2 <br />m <br />0 <br />co <br />m o <br />--� c <br />o� <br />m <br />� � <br />m' <br />A �. <br />C <br />D --I <br />r x <br />r-. � <br />--i N <br />K <br />O � <br />-n n <br />-i m <br />2 <br />m �-- <br />cn <br />0 <br />o r <br />c-� m <br />C Vf <br />� � <br />m <br />2 C'I <br />-i r <br />• m <br />n <br />A <br />� <br />S <br />a <br />z <br />� <br />x <br />N <br />2 <br />O <br />1 <br />(") <br />m <br />