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' �he £rer,ereen <br />c�rv o� <br />everett <br />CI7Y HALL 259�8745 <br />'�`� �;ONSTRUCTIOt�� <br />PERMIT <br />� <br />PERMIT N0. �-634g <br />EVERETT,WA9B201 � COMBINATION ❑ BUILDING ❑ MECHAI'�ICAL ❑ PLUMBING <br />OWNER MAILAOORESS CITY 21P PHONE <br />Lessley Construction, Inc. 10204 Bothell Everett Hwv 2 Hothell 98012 481-8866 <br />ARCHITECT OR OESIGNER MAIL AOORE55 CITY 21P PHONE <br />Impression Design 355-3200 <br />I GENERALCONTRACTOR MAII_AODNESS CITY ZIP PMONE LICENSEM <br />Lessley Construciton, Inc. same as above •Fr����vK <br />MECNANICALGONTRALTOR MAILADDRESS CIT1' 21P PHONE LICENSE� <br />Sazne <br />. PLUMBING CONTRACTOR MAIL AOOflESS CITY ZIP PHONE LICENSE � <br />Robinson Plumbing 743-9R56 <br />. CLASS OF WORN <br />� NEW ❑ ADDITION Cl ALTERATION ❑ FEPAIR J �EMOLITION O FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />f $0.000 <br />New sinqle familv residence - <br />LOT 13 BLOCN_OF <br />PLUMBINO <br />NO. TYPE OF FIXTURE CR ITEM <br />WAIER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHOWER <br />Y <br />5 <br />LAUNDRYTRAY <br />CLOTHES WASHEF <br />WATER HEATER <br />URIIJAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINKISFRVICF — FAR_ETCI <br />SUB TOTAL i <br />PERMIT f <br />TOTAL FEE S <br />�.EE7 SETBAGK FEAR YARD S <br />� i <br />AREA VACANT SI7E <br />g:YES �..:.NO <br />V-N <br />SIZE OF BLDG. NO. U <br />R = 1242 M = 440 <br />FIRE ZONE BASE <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILOING PLANS <br />3. FIRE MYDRANT <br />4. FIRE PROTECTION SYS7EM <br />5. GRADING <br />6. DRAINAGE <br />R-3 1 <br />F STORIES MA%. OCC. L( <br />1 <br />MENT FIRE SPRINKI <br />REOUIRED <br />-:YES '..�.NO <br />7.ENVIRONMENTALIMPACTSTATElAENT <br />8. HEALTH DISTRICi <br />APPLICATION ACC. BY <br />ru� <br />PLANS CHECKED BY I APPR. FOR <br />SG I LC <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 VIC ATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTi `9 <br />LOCAL LAW REGULATING CONSTRUCTION OR -!E <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATIIPEDP �OCI�CIOR OR AUTHORIZED AGENT OATE <br />MECHANICAI <br />TYPE OF EOUIPMENT <br />AIF 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 />FORCEG AIR SYSTEMS - B.T.U. M EA. <br />WALL HEATERS - B.T.U. M <br />UNIT HEATERS - O.T.U. M <br />EVAPORATIVE GOOLERS <br />CLOTHES 7qVERS <br />VLNTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEA7 PUMP <br />BUILDING <br />PLUMBING <br />MECHANICAI <br />OTHER Driveway <br />PENAL7V <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />FEE <br />ret <br />� <br />S <br />S <br />CHECK FEE <br />RECEIP7 NO. <br />• o <br />-- <br />1 11� � <br />7 111• 1': <br />�� <br />r�i . : � <br />::iM. . 1.1 <br />°�: � :i 1/ <br />� <br />20 <br />TOTAL � IE_tY7 �,?�_Sfl '�yl'ilJ�i�X <br />PERMIT VALIDATION � �ry(�.(y� <br />WHEN PROPERLY VALIDATF.D (IN PACE) Sb��T� UR PERMIT � <br />J�� f�.� � <br />1171-5 f224.00 � <br />CFfCI; t676.00 �.. ; <br />ADDRESS fILE <br />