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,he £,.P,R.�� ,O N STRU CTIO � <br />uTr or � -� ,,,A a., _ <br />everett PERMIT PERMIT N0. 1455� <br />CITV MALL 259 8745 <br />EVERETT, WA 9BP01 �I COMBINATION � BUILDIN(i � MECHANICAL � PLUMBINO <br />OWN R MFIL AODRE55 LITY Zlf PHONE <br />Dennia Kaupp 20429 N.E. 150th Street Woodinville 98072 788-5318 <br />•RGNIi OR UESIONER MAIL AO�RE55 CITY 21P PMONE � <br />N X�L CONTRACTOR MAIL ADDRESS CITY 21P PHONE IICE�SE � <br />$01118 <br />MECNAhIC�� CONTRl�CTON MnIL AOORE55 CITV ZIP PH�NE UCENSE � <br />PLUNBMa CONTP�CTOR ����L ADORESS CITY ZIP PNONE UCENSE / <br />$NEW ❑ ADDi;ION ❑ ALTERATION <br />VALUATION OF WORK <br />f 40�320.00 <br />DESCFIBE WORK <br />Construct Sinqle F,unily Residence <br />PROPOSEO USE OF BUILDItIG <br />Sinqle Family� Resid :nce <br />LEOAL DESCRIPTION OF PROPEPTY �SMOW IEIOW OA ATTACM FOUR ( <br />❑ REPAIR ❑ OEMOLITION � FENCF ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />�or? e�ocK � oF Int.ercity Addition Div. #1 <br />Lot 2 Short Plat �-84 <br />32S'West Marilyn <br />PLUMSINO <br />TYPE OF FI%TURE OR ITEM <br />BATMTUB <br />LAVATORY�WASHBASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHEP <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF ORAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />TOTAL <br />R-1 <br />io� <br />V-N R-3 M <br />� BLDCa. NO. OF STORIE <br />None <br />APVROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS - � <br />3. FIRE HYDRANT <br />/. FIRE PHOTECTION SYSTEM � <br />5. GRADING <br />�.ENVIRONMENTALIMPACTSTATEMENT <br />8. MEALTH DISTRICT - � - <br />" MPLICATION ACC. BY PCANS CME <br />EB HWM <br />FEE <br />+ 18 I 0 <br />f <br />f 18 00 <br />REFR YARD SETBACK <br />zo� <br />VACANT SITE <br />lC�i ES : : NO <br />NO. OF DWELLING UNITS <br />1 <br />MAX. OCC. lO�AO <br />BY <br />� <br />I HEREBY CEHTIFY 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 PREBUM=TO GIVE AUTHORITY TO VIOLATE <br />OR CAN THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL W REGUL TI CONSTRUCTION OR THE <br />PERF ANC OF C RU�TION. �) <br />SIGN F CONi ACTOfl AUTHORI. iD AGENT i . U'�TE �� <br />NO. TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT MEATEti$ — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANOLING UNIT — C.F.M <br />STOVE — WO00 <br />METAL FIREPLACE 8 CHIMNEY <br />FIFEPLACEINSERT <br />SUB TOTAL f � <br />PERMIT S <br />TOTAL FEE S 7 <br />< NUMBER PLAN CMECK FEE <br />85�14558 FEE ],57.63 RECEIPT <br />758i <br />FEES VALUATION FEE <br />ew�oinc <br />PLUMBING <br />MECHANICAL <br />UATE �THER <br />530,500. � 7.42 � 50 <br />18 00 <br />12 00 <br />PENALTY SEC. 309 �a) <br />TOTAL 2%2 SO <br />PERMIT VALIDATION " — � <br />WHEN PROPERLY VALIDATED 11N THIS SPACE) ,fiMIS IS VOUq {�ERMIT �� <br />� � <br />l.1") <br />�, .. Si' <br />� <br />' ADDRESS FILE <br />