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`�''��e�"�: ; ;' '� �ONSTRUCTI01� � <br /> eV��e'tt' :; ,�:;, <br /> P�RMIT PERMIT NO. 1630� <br /> � ��-��� � <br /> � �IY��INATION ❑ BUILDINQ I� MECHANICAL ❑ PLUMBING <br /> OWNER MAILADDflESS CITY ZIP PMONE <br /> MATTESON CONSTRUCTION 156 E. VISTA DEL MAR CAMANO ISLAND WA 98292 652-0575 <br /> qRCMITECT Ofl OESIGNER MAIL ADCRESS CRV ZIP PHONE <br /> GENERAL LONTFFCTOR MAIL AODRESS CITY ZIP PNONE LICENSE N <br /> Same <br /> MECNANICALCONTflACTOR MAII AODflE55 GT'f ZIP PHONE ULENSE� <br /> PLIIMBING CONTPAGTOR MAII AODREiS CITV 21P FMONE LICENSE II <br /> C1A55 OF WOPK <br /> DIFlEW ❑ P�ODI710N ❑ ALTERATiC1N ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VALIlATION OF WORK <br /> y rJ��000.�� <br /> �ESCflIBE WORN <br /> New single family residence <br /> PROPOSEO USE OF BUILUING <br /> Si ngl e family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> HPPLICATiON AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCHIFTION OF PROPERiY�SHOYI BELOW O°ATTACM FOUH COPIES� M QORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or�5 6WCK_OF West Cree't #2 GOVERNING THIS TYPE OF WORK WILL BE COMPUED WITH <br /> WHETHEN SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOC.4L LAW REGULATING CONSTRUCTION OR THE <br /> PEfiFURMANCE OF CONSTRUCTION. <br /> JOB ADORESS SIG RE OF CONTRAC R OR AUTHORR GENT OATE <br /> 10728 - 5th Ave SE i� �^" 4 4 86 <br /> PLUMBING ME NICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE I <br /> 2 WA7ERCLOSEryTOILEn 4 OO AIR COND.UWTS— H.P. EA. � <br /> � BATHTUB 2 OO REFRIGEHATION UNITS - H.P.EA. <br /> z LAVAT�7RY(WASH BASIN) 4 OO BOILERS- N.P. EA. <br /> � SHOWEP OO GAS FIRED A.C.UNITS-TONNAGE EA. <br /> KITCHEN SINKS DISP. OO FORCED AIR SYSTEMS- B.7.U. M EA. <br /> � DISHWASHER Z OO WALL HEATERS- B.T.U. M <br /> LAUNDRYTRAV UNIT HEATERS- B.T.U. M <br /> CLOTHES WASMER EVAPORATIVE COOLERS <br /> WATEFi HEATER � CLO7HE5 DRYERS 4 5O <br /> URINAL 2 VENTILATION FAN G OO <br /> DRINKING FOUNTAIN � RANGE HOOD 4 5O <br /> FLOOR DRAIN AIR HANDLING UNIT- C.F.M. <br /> VACUUM BREAKERS � STOVE-WOOD � 5O <br /> ROOF DRAINS- RAINLEAOERS METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE- BAR,ETC.) FIREPLACE INSER7 <br /> HEAT PUMP <br /> SUB TOTAL S SUB TOTAL S ZZ 5O <br /> PEHMIT S PERMIT S <br /> TOTAL FEE S TOTAL FEE S ZZ 5O <br /> SIDE YAPD SETBACK S7REETSETBACK REAR YARD SE78ACK PLAN CHECK NUMBER PLAN CHEGK FEE <br /> 6� 2(J� 2�' 86/16303 FE�d57C RECEIPTNO. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUA710N FEE <br /> R-1 7440 $P �ES ::NO <br /> TYPE OF CONST. OCGUPANCY GROUP NO. OF DWELLING UNITS <br /> V-N R-3 � BUILDING S 50 000. 283 00 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCG. LOA� <br /> R=1235 � PLUMBING 20 OG <br /> FIRE ZONE BASEMENT FIRESPRINKLERS MECHANICAL 22 5O <br /> REOUIRED <br /> .:YES ��.NO <br /> APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.303 lal <br /> 2.BUIL�INGPLANS -' ',U7AL 3Z5 5� <br /> 3.FIREHVDRANT ` <br /> 4.FIRE PROTECTION SYSTEN PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATED(IN THIS ISPAi EI THIS IS V,OU�R PE�MLT —O� <br /> ° ° L S ll <br /> 16.ORAINAGE (`�') <br /> 1�7.ENVIRONMENTALIMPA@i�TATEMENT !- rLQ <br /> =:S.HEALTHDISTRICT ��� . ,', �.i_Cl.�l 1 � ' <br /> "APPLICATION ACC.BY LANS CHECKED BY APPR. FOR ISSUANCE BY <br /> • ,-} <br /> . i'i ✓ <br /> a= 59 ; =� S g l c . � L, <br /> - - � <br /> _ ; <br /> � - ; ., d So <br /> � ADDRESS FILE <br />