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d+r Ercr��ren <br /> " � �' C4NSTRUCTIO�' ' <br /> everett P E R M I T <br /> CITYMALL259�B7a5 aERnn�r No. 15433 <br /> EVERETT.WA98201 � COMBINATION <br /> CXi BUILDING ❑ MECHANICAL �I PLUMBING <br /> owr�ee <br /> Ted Hall '"^��^ooNess ��ry Zp <br /> 3016 Victor Place Pnor+e <br /> aNcnrtecror+oesmrvce Everett 98201 252-0562 <br /> MAit nC�N[ss citr zio <br /> PHONE <br /> GENERA��ONiqqGiOR M4��pDDRE55 <br /> DeLeon Custom Homes "r� z�P anoHe ucervse� <br /> 24123 23rd S.E. Bothell <br /> NeceaHicn�coNinncroa Mni�nooaess 98021 347-1378 <br /> CItY ZIP PnONE LiCENSE r <br /> PIUMBING CONTqqptOR EDLEACli156JH <br /> MRI��O�RES$ ��JY Zp <br /> PHONE LiGENSE� <br /> GUSS OF WORK <br /> ❑NEW O ADDITION ($qLTERATION ❑qEPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVEtFIPEPLACE INSEFT <br /> VRLURTION OF WORK <br /> s �.7�00�.0� <br /> �ESCRIBE WORN <br /> New Roof, New Siding, Deck, Dath remodel, new windows � <br /> PROPOSED USE OF 6WLDiNG <br /> Single Family Residence Chip Rehab I HEREB}•CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � <br /> �ecn�oescnianoNOFaaocearr�snowae�owonarrncrvuuacoviesi APPL�CATION AND KNOW THE SAME TO BE TRUE AND �� <br /> CORHECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> ioT 9 e�ocK 5 0� Ready Land Com an s lst GGVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR N07.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR "3 "7 <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE t+ ,�y <br /> �oa nooaes; — PERFORMANCE OF CONSTRUCTION. � � <br /> 3016 Victor Place SIGNAiURE OF CONiqA�TOR qR qUiHOFIZEp PGMT DAiE ���"""lll <br /> PLUMBINC 9I17 85 � <br /> MECHANICAL � <br /> NO. TYpE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> WATER CLOSET(TOILET) FEE � <br /> AIR COND.UNITS- H.P. EA. <br /> I. BATMTU9 REFRIGERATION UNITS— H.P. EA. � Z <br /> 1 LAVATORY�WASNBASIN� BOILERS— y <br /> SMOWER H.P. EA. <br /> GAS FIqED A.C.IINITS— y <br /> TONNAGE EA. �-! N <br /> 1 NITCHEN SINK 8 DISP. FORCEO AIR SYSTEMS— B.T.U. M EA. � <br /> DISMWASMER WAIL HEATERS— B.T.U. M O � <br /> LAUNDRY TRqV UNIT MEATERS— B.T.U. M y <br /> CLOTMES WASHER EVAPORATWE COOLERS -- $ <br /> 1 WATER HEATER 2 _ Ch N <br /> CLOTNESDRVERS <br /> URINAL y[NTILATI04 FAN 8 ['� <br /> DRINKING FOUNTAIN (� �T <br /> RANGE HO00 <br /> FLOpP DRAIN AIH HANOLI�'G UNIS- a � <br /> VACUUM 9REANERS GF.M. k/ � <br /> STOVE- WOOD .`� <br /> ROOF DRAINS- RAINLEADERS <br /> METAL FIqEPLACE 8 CHIMNEY <br /> SINN�SERVICE - BAR,ETC.� <br /> — PIREPLACLINSERT <br /> — HEAT PUMP y <br /> z <br /> � <br /> r, <br /> __ SUB TOTAL f ].O OO SUB TOTAL f �y <br /> _ PERMIT S _ PERMit O <br /> TOTALFEE f y <br /> s TOTAL 1=EE ; kn <br /> S!DE VARD SETBACK STFEET 5[TBACK REAR VARO SETBAGK P�AN CMECK NUMBEfl (+7 <br /> PLAN CNECK FEE <br /> USE ZONE LOT FREA VACANT SITE FEE RECEIPT IJO <br /> . 1'ES NO FEES VALUATION FEE <br /> iYPE OF CONST. OCCUPANCY GROUP NO.OP OWELLING UNITS <br /> SIZEOFBLDG. NO.OFSTOqIES MAX.00G �OAO BWLDING E ].'/�OOO. <br /> — 122 $0 <br /> PLUMBING <br /> PIRE ZONE BASEMENT FIRE SPRINHLERS lO OO <br /> REOUIFLD MECHANICAL <br /> VES NO <br /> APPROVALS BY OATE OTNEq <br /> 1. ENVIRONMENTAL CNECK LIST <br /> 2.BUILOING PLANS ��� — PENALTY U B.C. — <br /> SEC.303�a� <br /> 3 FlREMVDRANT �w TOTAL L3Z SO <br /> <.FIRE PROTEC710N SVSTNT <br /> PERMIT VpLIDATION ,y. n <br /> S.GRA�INu � WNEN PROV[RLY VAUDATED�IN THIS�,f�Ayea1HI5 1�Y���G�R (Y')� <br /> '-6'DRAINAGE , - � �' <br /> .ENVIRONMENiALIMPA�yTATEMENT � <br /> [�jnea�rr+:orsTai r — , . ; ,'; {:':C�I i'f^ <br /> APPIICAT101J q��. OY • LANS CHECKED BV qppp.FOR ISSl1ANCE BY <br /> o-� . <br /> �, - :�> � ' ^.ivF: 1'C:� U' � <br /> , , ,, � , . <br /> - � =- <br /> I 7 ���° $5 <br /> :� , <br /> ;.����;:���,;; ������ <br />