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� <br />I; ldl3���0�;;�;,� �ONSTRUCTIOI� � <br />�VQi�'� �ERMIT PERMIT NO. 16Z61 � <br />� crt�-"�Q����•� � 5 0 8 I <br />�EVERETT'WA9�20� COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBIN(i <br />OWNER M�ILAUDRESS CITY 21P GMONE <br />Leseley Oonstruction, Inc. 18204 Bothell Everett Hwy #2 Bothell 98012 4(:1-8866 <br />AflCHI!ECT OR DESIONER MAIL ADDNESS CITY 21P VXONE <br />Iapreesion Design 355-3200 <br />GENEfl�L CONTRACTOR MAI� ADDRESS CITY ZIP PHONE LICENSE � <br />Leasle:- �nstruction, Inc. LESSLIk46i 210PK <br />MECHf:dCAL CONTHACTOR MAIL ADDRESS CITY Z:P VHONE LICENSE I <br />a:ie <br />PLUMBING CONTR4CTOfl MAIL AOURE55 dTY 21P �� PMONE LICENSE / <br />Robinson Pltm�bing 745-9858 <br />cuss oF woF� <br />� NEW ❑ ADDITION ❑ ALTERATIJN ❑ REPAIq ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPIACE INSERT <br />f QWcYBo 50, 000 <br />DESCRIBE WORK <br />Single family residence, Basic Plan 1249 <br />Single family residence <br />LOT <br />1513 - Slst P1 SW <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />2 WATERCLOSETITOILET� <br />y BATHTUB <br />SHOWER <br />1 KITCHEN SINK & DISP. <br />], DISHWASHER <br />LAUNDRVTRAY <br />1 �IOTHES WASHER <br />1 WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS - RAINLEADERS <br />SINK (SERVICE �- BAR, ETC.) <br />6' <br />SE ZONE <br />R-1 <br />YPE OF C <br />V-N <br />�ZE OF Bl <br />FZ J <br />M = <br />SUB TOTAL S <br />PERMIT S <br />TOTALFEE S <br />IEET SETBACK RE <br />20' <br />'AREA VA <br />x= � <br />:UPANCY GROUP NO <br />R-3 <br />APPfl0VAL5 <br />1. ENVIRONMENTAL CHECK LIST <br />2.BUIL�INGPLANS — <br />3. FIRE HYDRANT `' <br />/. FIRE PROTECTION SYSTfiyli <br />S.GRAOING � <br />6.DHAINAGE . <br />#E�JVIRONMEN7AL IMPACiT�£TATI <br />'gHEALTHDISTRIC7 r�� <br />� <br />C) <br />�M.M. (`�; .-�,�i <br />�BTG <br />BY <br />FEE <br />� 1 � <br />I HEREBY CER'fIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION A�D KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PAOVISIONS OF LAWS AND ORDINANCES <br />GOVERNING TH!S TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHEF STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFOR NCE CONSTRUCTION. <br />SIGNATURE O��1T/1�4 OH OR AUTHORILD AGENT /�O ATE <br />X c f . //.���-sr�sl� / � /�� <br />MECMANICAL <br />N0. TYPE OF EOUIPMENT <br />AIR COND. UNITS - H.P. EA. <br />REFRIGERATION UNITS - E P. EA. <br />BOILERS - H.P.E4. <br />GAS FIRED A.C. UNITS - 70NNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />WALL HEATERS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />]_ CLOTHES ORYERS <br />2 VENTILATION FAN <br />1 RANGEHnO� <br />AIR HANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />1 METAL FIREPLACE 8 CHIMNEY <br />FIREFLACE INSERT <br />HEAT PUMP <br />20' 86/16�61 <br />!T SITE <br />NO FI <br />� DWELLING UNIT� <br />1 J BUILDING <br />)CQ LOAD <br />PLUMBING <br />PRINKLERS A�ECHANICAL <br />RED <br />�: NO - <br />DATE OTHER <br />_ � ENALT'/ <br />TOTAL <br />L.C. <br />SUB TOTAL f <br />PERMIT S <br />TOTAL FEE f <br />FEE <br />4 <br />FEE Bd51C I RECEIPT NO. <br />VALUATION I FEE <br />S 50,000 <br />325 <br />PEqM1T VALIDATION <br />WHEN PROPERLY VALIDATED (IN THISISpl�J � THIS �%0� �PEO CT'— C� <br />Z• � <br />N <br />c_n <br />_ . � _� <br />. i..l.C{I'�� � <br />'i' : ' 'J <br />ADDRESS FILE <br />, „� <br />- I „i�� uu <br />