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rhe £cer,�reen <br />c�rv o� <br />everett <br />CITY HALL 259-8745 <br />r� �:ON�'�'l�UCTION-- <br />PER�IAIT <br />.- <br />PERMIT NO. 1U34� <br />EVERETT,WA90201 � COMBINATION ❑ F3UILDING ❑ MECHANICAL ❑ PLUMPING <br />OWNER MAIL ADORESS CITY ZIP PHONE <br />LESSLEY CONSTRUCTION 18204 Eothell Everett Hwy Bothell WA 98012 481-8866 <br />ANCY.ITECi OR DESIGNER MPIL A�DRE55 C:7Y ZIP PHONE <br />GENERALWNTRACTOR MAILA�DRESS �IiY 21P PMONE LICENSEN <br />Same <br />MECMFNICAL CONTRACTOR MAIL ADDflESS QTY ZIP PIIDNE LICENSE N <br />PLUMBING WNTRACTOR MAIL ADDflESS CITY 21P �� PMONE LICENSE N <br />C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORY. <br />f 50�0��. <br />OESCRIBE WGflK <br />New single familyr residence <br />PROPOSED'JSE OF BUILDING <br />Single famil.y residence IHEREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHIS <br />�oT �$ p',OLK_OF ��i> > ow Creek Gl en <br />1518 - 51st P1 SW <br />PLUMBIN6 <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />DI�HWASHER <br />LAUNDRY TR.4Y <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNiFIN <br />FLOOR �RAIN <br />VACUUM BREANERS <br />ROOF DRAINS - RAINLEADERS <br />SINK (SERVICE - BAR, ETQI <br />6' <br />USE ZONE <br />R-1 <br />7YPE OF CONST. <br />V-N <br />SIZE OF BLDG. <br />PEqM1T <br />70TAL FEE <br />REET SETBA� <br />20' <br />i AREA <br />CUPANCY GI <br />R-3 <br />. OF STORIE: <br />2 <br />L ENVIRONMEFTAL CHECK LIST <br />2. BUIL�ING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />B. HEALTH DIS7RICT <br />sg <br />FEE <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 Gr�ANTING OF A <br />PEflMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHEF STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORb(ANCE OF CONST�TION. <br />SIGNATUR�OF CONTRACTOR OR AOTT�O ED AGENT DKfE � <br />X —� �— ����%i/e <br />MECNANICAL <br />NO. TYPE OF EOUIPMENT <br />AIR COND. UNI75 - H.P. EA. <br />REFRIGERA710N UNI7S - H.P. EA. <br />BOILERS - H P. EA. <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />WALL HEA�fERS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />1 CLOTHES �RYERS <br />RANGEHOOD <br />AIR HANDLING UNIT - <br />STOVE - WO00 <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />+ ZO 00 <br />S <br />S 2� �� <br />EAR YARD SETBACK PLAN CHECK NUMBER <br />20' 86/16342 <br />ACANT SI7E <br />YER �;NO FEES <br />O.OF DWELLING UN!7S State Bldg Surch <br />1 rergy-Snr <br />BUILDING <br />AX.00Q LOAD ._—_. <br />PLUMBING <br />REOUIRED <br />-_:VES ..NO <br />PLANS CHECKED BY qPpq, FOR ISSUANCE BY <br />59 lc <br />MECHANICAL <br />C.F.M. <br />SUB TOTAL f <br />PEHMIT S <br />TOTAL FEE S <br />PLAN CI <br />FEEbasic <br />VALUATION <br />$ 0 <br />� <br />�11�2 <br />FEE <br />RECEIPT N0. <br />FEE <br />OTHER Drivewa E$�l'�ii :$1 .� 2Q Q� <br />PENALTY 03�a) SG .00 <br />�Q__ <br />rorn� 359 00 <br />PERMIT VALIOATION �� s� � <br />WHEN PROPERLY VPLIDATED (IN,TNlS.SPAGp THIS IS YOUR PERMIT ,Z <br />@UWCJl1! <br />� 4�.� i.l^� <br />ll�i—�J �4.� (f-: <br />���.3 _ � <br />�� 5�.� . . <br />C1iCt: 5673.00 <br />ADDRESS FILE <br />