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flu, Evergreen <br />In `)I ITY Or H1 '� <br />AY-*M n o <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 COMBINATION <br />CONSTRUCT'ON <br />PERMIT <br />BUILDING - MECHANICAL - PLUMBING <br />everett <br />,,e. <br />---""' U U I I V i 2 6 G L MAIL ADDRESS PHONE <br />Dujardin Construction P.O. Box 5308 Everett 98206 334-5018 <br />ARCHITECT Ofl DESIGNER MAIL ADDRESS Pi1UNE LICENSE NO. <br />,D <br />R1 <br />z <br />C <br />e hHAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO, <br />Same DU JA RC H305B6 <br />MECHANICAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />9 <br />W <br />p M <br />PLUMBING CDNTR ACTOR MAIL ADDRESS PHONE LICENSE NO. <br />L% <br />CID <br />PERMIT <br />❑COMBINATION <br />(� BVILDING ❑PLUMBING ❑MECHANICAL <br />CLASS OF WORK <br />�p <br />�p NEW ❑ADDITION ❑ALTERATION ❑REPAIR <br />Q1 <br />VALUATION OF WORK - <br />S 48r600.O0 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br />DESCRIBE WORK - - ---- <br />Construct single family residence <br />PROPOSED USE <br />single family residence <br />MECHANICAL <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIES) <br />LOT L BLOCK 24 of Town Of Lowell <br />TYPE OF ENERGY <br />❑GAS ❑ELEC. <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />AIR COND. UNITS-H.P. EA. <br />$ I <br />REFRIGERATION UNITS-H.P. EA. <br />53oy C 5-28-5 <br />BOILERS-H.P. EA. <br />) <br />FORCED AIR SYSTEMS-B.T.U. MEA. <br />100 <br />1 <br />JOB ADDRESS <br />--&&6 South NX?JXaIXXyX 3rd Avenue <br />SPACE & WALL HEATERS - B.T.U. <br />UNIT HEATERS-B.T.U. <br />I <br />P�I!RiBING <br />EVAPORATIVE COOLERS <br />1 <br />CLOTHES DRYERS <br />3100 <br />1 <br />VENTILATION FAN <br />2 00 <br />1 <br />RANGE HOOD <br />3 100 <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR HANDLING UNIT- C.F.M. <br />BATH TUBS <br />S <br />I - <br />1 <br />CLOTHES WASHER <br />1On <br />WATER HEATER <br />DISH WASHERS <br />Z 100 <br />DRINKING FOUNTAINS <br />I <br />FAC. BUILT FIREPLACE & CHIMNEY <br />I <br />FLOOR DRAINS <br />I <br />GAS. SYSTEM: NO OP OUTLETS <br />KITCHEN SINKS & DISP. <br />2I <br />SUBTOTAL S <br />I <br />BAR SINKS <br />PERMIT S <br />ROOF DRAINS - RAIN LEADERS <br />TOTAL FEE SI <br />114 I nn <br />SHOWER BATHS <br />THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC <br />TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS. OR IF <br />CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />5/25/79 <br />x u�7 <br />SERVICE SINKS <br />SUMPS - SEWAGE PUMP <br />URINALS <br />WATER CLOSETS <br />4 I no <br />WATER HEATERS - ELECTRIC <br />I <br />WASH BASINS4 <br />I 00 <br />LAUNDRY TRAYS <br />I <br />SUB TOTAL <br />PERMIT <br />S <br />TOTAI. FE <br />s <br />WATER <br />SERVICE 512E BLDG. SUPPLY <br />SIZE <br />SIG ATUREOF CONT AC <br />OROR AUTH. AGENT DATE <br />SIDE YARD SETBACK <br />51 <br />STREET SETBACK <br />201 <br />REAR YAROSETBAC <br />201 <br />PLAN CHECK NUMBER <br />79/342 <br />PLAN CHECK FEE <br />FEE RECEIPT NO. <br />92.00 39373 <br />USE ZONE <br />R-2 <br />LOT AREA <br />7200 Sq. Ft. <br />VACANTSITE <br />❑yEs ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP NO <br />UNITS <br />R-3 <br />-OF DWELLING <br />1 <br />I <br />BUILDING <br />S481 600. 00 <br />184100 <br />S1ZE OF BLDG. <br />361 x381 <br />NO. OF STORIES <br />1 <br />MAX.00C. LOAD <br />PLUMBING <br />I <br />18 00 <br />FIRE ZONE <br />3 <br />BASEMENT FIRESPRINKLERS <br />yes REQUIRED <br />OYES 11NO <br />MECHANICAL <br />I <br />131 00 <br />SPECIAL CONDITIONS: <br />— <br />OTHER <br />1 <br />1 <br />N <br />PENALTY <br />SEC. 303(a) <br />I <br />TOTAL r <br />215100 <br />w <br />T <br />C M <br />PERMIT VALIDATION <br />( 1` OY '111 0 0 1 <br />WHEN PROPE RLV VALIDATED (I3�tI1�S3SPACEtTftg 45 Y ff! PERMITCIO <br />YO;U.R RECEIFTD <br />THANK YOU Co <br />� Q <br />o — <br />•Ilrnno :I IxY <br />-i <br />I xst.HIIRIIIIIr nrxnovloI.f!IMxnNCIHY. <br />V.C. <br />W - ADDRESS FILE <br />