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the Evergreen <br /> CITY OF r, `.ONSTRUCTION- . <br /> everett PERMIT PERMITNQ::17515 <br /> 259 -8745 <br /> ❑ DEMOLITION DI COMBINATION 0 BUILDING 0 MECHANICAL 0 PLUMBING ❑ SIGN <br /> OWNER MAIL ADDRESS CITY ZIP PHONE <br /> RICK PULLIAM 2116 - 228th St SE Bothell WA 98021 481-9292 <br /> ARChITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHON: <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE' <br /> Same <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE■ <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE P <br /> CLASS OF WORK <br /> ❑ NEW 0 ADDITION 0 ALTERATION [XI REPAIR 0 DEMOLITION 0 BUILDING RELOCATION <br /> VALUATION OF WORK <br /> 18,000.00 <br /> DESCRIBE WORK <br /> Replumb, wire, sheetrock, insulate existing building <br /> HEAT SOURCE <br /> ❑ ELECTRICITY 0 GAS ❑ WOODSTOVE 0 OTHER <br /> PROPOSED USE OF BUILDING <br /> Residence - Duplex I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCR PTIONO"PROPERTY SHOW RELCW OR ATTACH fO;IR1co ) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LO1 BLOCK i ! OF pie, P y_,L / JJ-6-1 dv✓ GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES ''OT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> � a STAT- R <br /> -O 't9C:•L LAW REGULATING CONSTRUCTION OR <br /> ,_ 6/f7 fr/ C/?/ly lite Tf E PERFORMANCE yl TRUCTION. <br /> JOB ADDRESS IGNATURE .ONTRACTOR UTAGENT.OR OWNER DATE <br /> 3�8'bn& 36 �1Col by t•-"'- C --„A______ 12/2/86 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE _ <br /> 1 WATER CLOSET(TOILET) 5 00 A C-A.HNDL G UNITS-H P -. <br /> 1 BATHTUB 5 00 REFRIGERATION UNITS- H P EA <br /> 1 LAVATORY(WASH BASIN) 5 00 BOILERS-B T.0 iH P i2 2?f,1f i��}(S till':I <br /> SHOWER GAF f IRED A C UNITS- B;202/°6 <br /> 1 KITCHEN SINK&DISP 5 00 FORCED AIR SYSTEMS---B160041.6 <br /> 1 DISHWASHER 5 00 WALL HEATERS-B T U <br /> LAUNDRY TRAY UNIT HEATERS—B T LI �" M17,-00 <br /> 1 CLOTHES WASHER 5 00 EVAPORATIVE COOLERS tt..t13 $Z0. 16 <br /> URINAL 1 CLOTHES DRYERS C 'H ?1 6 50_ <br /> DRINKING FOUNTAIN VENTILATION FAN 0242 <br /> FLOOR DRAIN RANGF HOOD CLEC $:t0.10 <br /> BACKFLOW PREVENTERS 1 WATER HEATER • 01300173156 ,1)_ <br /> ROOI-DRAINS-RAINLEADERS WOOD STOVE r1�OQ �2�'� <br /> SINK(SERVICE-BAR,ETC) METAL FIREPLACE&CHIMN!4- 30' 3 <br /> FIREPLACE INSERT MEM $13.00 <br /> HEAT P:'MP t t $1.A'" <br /> GAS PIPING 1r000a6z47. <br /> EXHAUST FAN CLEC SN 1I <br /> CHEM t•.tE .I.JG <br /> SUB TOTAL S 30 00 SUB TOTAL $ 13 00 <br /> PERMIT S PERMIT $ <br /> TOTAL FEE S 30 00 1 TOTAL FEE $ 13 00 <br /> FRONT SETBACK REAR SETBACK SIDE SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> ❑Yes E.]NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO OF DWELLING UNITS BUILDING 518 000. 189 00 <br /> f LUMPING <br /> SIZE OF BLDG. NO OF STORIES MAX OCC LOAD 30 00 <br /> MECHANICAL 13 00 <br /> INVESTIGATION FEE Sec.304(e) <br /> FIRE SPRINKLERS MOORED 0 YES 0 NO <br /> STATE BUILDING SURCHARGE 1 50 <br /> STATE ENERGY SURCHARGE <br /> APPLICATION ACC BY PLANS CHECKED BY APPR FOR ISSUANCE EV <br /> DRIVEWAY PERMIT <br /> sg 1c TOTAL 233 50 <br /> PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(114 THIS SPACE)THIS IS YOUR PERMIT <br /> U) <br /> 1.-- <br /> LI? <br /> ADDRESS FILE r <br />