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(Ihe�Bvelyereen ; -.� - ;ONSTRUCTIO�� / <br />, � � ,,... CiTyp� j. . . <br />everett p�R��T PERMIT N0. 1�2o�J <br />CITY HALL 259�87a5 <br />�/ E""E"ELT•��G9�291;� l�('�111�I�INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNEF MNIL AppRE55 CITV ZIP PMONE <br />LESSLEY CONSTRUCTION 18204 BothellFvarPtt _Nw,v_H9 Rnth,��7��ygni? qg�_886� <br />AflCMITECT OR OESIGNER MAIL AODFE55 CITY ZIP PHONE <br />GENERALCONTFACTOfl MP': ACDRESS CITY ZIP PHONE LICENSEN <br />Same <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSE Y <br />PLUMBING CONTRALTOR MAIL AODRESS CITY ZIP PHONE LI^ENSE N <br />NEW ❑ A�DITION ❑ ALTERATION I] REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S 5����0.�0 _ <br />UESCRIBE WOPK <br />e famil <br />LOT z� BLOCK_OF W����N% Cre� <br />i08 AODNE55 <br />1524 - 515t PL SW <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />WATEH CLOSET (TOILET� <br />1 BATHTUB <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATEP. :iEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAK.ERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />SIDE Vl.FD SE7BACK STREE7 SE76A <br />6' 20' <br />I1SE ZO'JC LO7 AREA <br />R-1 <br />T1PE OF CONST. OCCUPANCV G <br />V-N R-3 <br />SIZE OF BIDG. NO. OF STORIE <br />R=1415 1 2 <br />FIRE ZONE BASEMEN7 <br />APPNOVALS <br />t. ENVIRONMEN7AL CHECK LIST <br />2. BUILDING PLFNS ti <br />3.FIREHYDRANT �' <br />4. FIRE PRO7ECTION SYSTEM <br />5. CRADING <br />6.ORAINAGE <>`+ <br />7.ENVIRONMENTALIMPACT�STATEMENT <br />=�8. HEALTH �ISTRICT <br />c APPLICA710N ACC. <br />�_ <br />FEE <br />> 24 01 <br />S <br />s 24 �� <br />REAR YAfiD SE7BACK <br />20' <br />(-'fES '.NO <br />NO. OF DWEL <br />1 <br />h1Ax. OCG L( <br />FIRE SPRINKI <br />REQl11RE0 <br />YES . NO <br />BY <br />��PLANS CHECKE� BY APPR. FOR ISSUANCE BY <br />� sg lc <br />_U <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAAAINED 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 VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OT!�ER STPTE OR <br />LOCAL L� W REGULATING CONSTRUCTION OR THE <br />PERFORbfAN6E OF_CONSTRUCTION. / / <br />SIGNATIIP}�dF CObIfi�C�pii OR AUTHOflRED AGENT �AiE <br />MECHANICAL <br />AIR COND. UN�TS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNI75 — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEA7ERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VEN7ILATION FAN <br />RANGE HOOD <br />AIF HANDIING UNIT — C.F.N. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />86/16264 <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />SUB TOTAL S <br />PERMI7 S <br />TOTALFEE S <br />PLAN C <br />FEEbdS1C <br />VALUATION <br />50,000. I <br />RECEIPT NO. <br />FEE <br />283 00 <br />24 00 <br />19 50 <br />WHEN PROPERLY VALIDA7ED QN THIS SPACE) THIS IS YOUR PERy11T Cr <br />IZ/" �?�J.�'� (:U <br />r� <br />� i:.' � . <br />. 1 <br />ADDRESS FILE <br />�, .... .' l� ,i <br />