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tM EWEVW A "PLICATION FOR <br />GTYOF %.ONSTRUCTION e <br />everett PERMIT <br />DEPT OF COMMUNITY DEVELOPMENT SERVICES <br />CITY HALL 259-6745 F-� <br />EVERETT, WA 98201 COMBINATION El BUILDING ❑MECHANICAL L)PLUMBING PERMIT NO. <br />OWNER ,S_.eAII ADDRESS CITY ZIP 3� rnoN! , <br />—Nno �uR UISIGNtK MAIL ADDRESS - --CPIY -- I - -Y•IP" PHONE <br />Scott Kirkland 13004 Hilltop Road Arlington, Wa. 98223 653 3978 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />C! <br />KFQOIY"Tii� <br />Bill Krueger <br />10109 Kenwanda Dr. <br />Snohomish, ,Wa. <br />98290 <br />668 2000 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE R <br />NUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSER <br />CLASS Of WORK t�77,,"",,`` <br />❑NEW ❑ADDITION ki%TERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOCATION <br />VALUATION D/ WORK <br />S 25,000.00 <br />DESCRIBE WORK <br />Master Suite addition(upper floor), relocate interior walls, new kitchen cabs. <br />PROP.MD USE of BUILDING <br />Single Family Residense(owner occupy) <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN <br />OR NOT THE GRANTINC OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERF RMANCE OF CONSTRUCTION. <br />SIGNATURE ONTRA OR AUTHORIZED ACENT DATE'7-7-82 , <br />t INrklanf9 <br />LEGAL DESCRIPTION Of PROPFRIYISHOWN @FLOW OR ATTACH FOUR COPHSI <br />lot BLOCK_OF <br />S@@ S1T.e lEIR <br />_ <br />S <br />JOB ADDRESS <br />06 2 th. West Everett WA. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOLIET) <br />)f <br />ONO UNITS -HP EA <br />BATHTUB <br />GERATION UNITS-H P FA <br />LAVATORY(WASH BASIN) <br />LrCJRS-HP <br />EA <br />SHOWER <br />IRIDAC UNI7S-TONNAGE EA <br />KITCHEN SINK L DISP <br />)ED <br />AIR SYSTEMS -BTU MFA <br />DISWASHER <br />HEATERS -BTU M <br />LAUNDRY TRAY <br />HEATERS-B T U M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />F <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />I <br />VENTILATION FAN <br />C[l <br />DRINKING FOUNTA)N <br />( <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT— C F M. <br />VACUUM SRI AKERS <br />STOVE <br />ROOF DRAINS—RAINLFADERS <br />METAL FIREPLACE L CHIMNEY <br />SINK (SERVICE —BAR. ETC I <br />EUB TOTAL <br />$UB TOTAL S <br />PERMIT <br />L <br />PERMIT S <br />TOTAL FEE <br />E <br />- TOTAL FEE IF <br />SIDE YA110 <br />1 <br />SETBM:K <br />2 P <br />STREET SETBACK <br />2 �T <br />REAR YARD SETBACK <br />25F <br />PLAN CHECK NUMBER <br />�5Z ro7E <br />o—o—PLAN CHECK FEE <br />FEE RECEIPT✓7 [Lj <br />USE ZONE <br />- S <br />LOT AREA <br />VACANT SITE- <br />❑YES 0If6 <br />FEE$ <br />VALUATION <br />FEI <br />TYPE OF CONST <br />N <br />OCCUPANCY GROUP <br />AQEW-TN f;� 3 <br />NO Of DWELLING UNITS <br />I <br />BUILDING <br />f q�.-.<,C„� <br />LL�J l <br />1 <br />l <br />SIZE OF BLDG <br />Z!-VFLF.- 5%; •J• <br />NO OF STORIES <br />2 <br />MAX OCC LOAD <br />— <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />BEDROOMS <br />3 <br />FIRE SPRINKLERS <br />REQUIRED� <br />❑YES E➢PO <br />MECHANICAL <br />(. <br />APMOVALS <br />RY <br />DATE <br />OTHER <br />1 ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BC. <br />SEC. )B)(a) <br />2 BUILDING PLANS <br />) FIRE HYDRANT <br />TOTAL <br />L FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT <br />"U <br />TV.1EJ�t'lti E UE �b1=—� A e, _v <br />S GRADING/EXCAVATION L CLEARINCIGRUBBING <br />6 DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />L HEALTH DISTRICT <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APMI FOR ISSUANCE BYL�C� <br />D <br />9-1.79 <br />