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�� " cONSTRUCTION - /� c <br />- everett PERMIT PERMITNO. � 7`��U <br /> 259 -8745 <br /> ❑ DEMOLITlON ❑ COMBINATION �] BUILDING ❑ MECHAWICAL ❑ PLUMBING ❑ SIGN <br /> 7�EA MnILADDRE55 CITV 21P PMONE <br /> Ble:ler & Sons Znc. 2124 - 139th P1 SE Bothell, WA 98012 745-8375 <br /> pqCryITECTORDESiGNER MAILAOORESS CIT1' ZIP PHONE <br /> GcNEF/LCONiR�GTOR :AARADDRE55 CITY Z�P PMONE LICENSE� <br /> Same as above BLEILSI174MG <br /> MECHANICAL CONTflACTOH MAIL ADORE55 CITY 21P PMONE LICENSE� � <br /> PLUMBING CONTFACTOH NAIL ADDRE55 CITY ZIP PHONE 4f,EN5E� <br />' LU55OF WONK <br /> ;EJ NEyy ❑ ADDITION 0 ALTERATlCY ❑ REPAIR ❑ DEMOLITION ❑ BUIIDING HELOCATION <br /> VALUATION OF WORK <br /> S 60,000 <br /> DESCRIBE WORK <br /> New construction s!f res. <br /> HEATSOUPCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> i <br /> PPOPOSEDUSEOFBUILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> single family residence qppLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCFiGTiONOFPPOPERTVISHOWBELOWORATfACHFOI/PCOPIES� CORRECT. ALL PROVISIONS OF I.AWS AND ORDINANCES <br /> 10 I9estcrerk Div. II GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �or_.e.ocK __ oF —.. WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF _'ONSTRUCTION. <br /> JOBAD�RESS SIGNAT�II jE 4FC_ONTRACT R.% T�R�IZ�F.�p/��nGENT.OROWNER DATE�/ <br /> 10705 - S�h Ave SE X ;,�(OU�Q�-J� �1�iXY.(xw� ��-p8''�^�-' <br /> d <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEIA FEE NO. TYPE OF EOUIPMENT FEE <br /> 3 WATEF CLOSET(TOILET� ZS OO aC-A�HNDLG UNITS-H.P. _ <br /> BATHTUB REFRIGERATION L'NITS-H.P.EA. <br /> LAVATORV�WASHBASIN) 1S BOILERS-BT.U/H.P. <br /> 1 SHOWER 5 GAS FIRED A.C.UNITS-P T.0 _ <br /> 1 KITCHEN SINK 8 DISP. S OO 1 FORCED AIR SYSTEMS-B.T.U. M EA. 9 OO <br /> DISMWASHEfl WALL HEATERS-B T.U. M <br /> LAUNDRVTFAY UNITHEATERS-BT.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> UFINAL CLOTHESDRYERS O <br /> DRINKING FOUNTAiN VENTILAT!ON FAN <br /> FLOOHORAIN RANGEHOOD C� SO <br /> BACKFLOWPREVENTERS WATERHEATER 6 SO <br /> ROOF DHAINS-RAINLEADERS WOOD STOVE <br /> SINK�SERVICE-BFR,ETC.) 1 METALFIREPLACEdC111MNEV 3O OO <br /> -- FIREPLACEINSERT <br /> HEATPUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br /> SUB TOTAL f 5 S1:8 TOTAL ` S :.:.� <br /> PENMIT S PE � - ' <br /> TOTAL FEE f TOTAL FEE <br /> FR ETBACN RFAR SETBnCK SiDE SETOntK PLAN CHECK NUMBER F RECEIPT NO. <br /> 20, Zp� �,� 86/17466 2 B'16B �4 .5083373 <br /> USE 20NE LOT ARER yn�qNT SIT[ FEES ATION � O FEE <br /> R-1 i692 Sires ❑�o <br /> TYPEOFCON.T. OLLUPANCYGROUP NOAFOWELUNGUNITS <br /> BUILDING �EF8�d00. •� 459 50 <br /> V-N k-3 1 PLUMBING p��p� $^, ,QQ SS 00 <br /> SI2E OF BLDG NO OF STONIES MAX OCC ID�D t{0[1t105269 <br /> 2043 1�4 - _ MECHANICAL . � 6� SU <br /> INVESTIGATION FEE ���� • <br /> FIRE SPRINKLERS REOUIRED ❑�ES L�F NO STATE BUI!DING SURCHARGE ��� g '� 1 SO <br /> STATEENERGVSURCHARGE 7 _5 qb. .00 15 00 � <br /> APP.ICRTION ACC BY PLANS CHECKED BY RPPR FOB iSSUANCE BV <br /> DRIVEWHYPERMIT ���� q16 '� 20 OO <br /> JEF L-C• TOTAL 618.50 <br /> M.M. <br /> -- PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED�IN THIS SPACE TH151S VOUR PEFMIT CD <br /> ��!��2���� � s � �J �1.--�'ZAc.� e��, � <br /> � <br /> � <br /> ; , .,:_s f;_.. <br />