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(Il(e�L�E�rr�iren, , <br />, .; ;. ,�,;�a� �� �ON <br />everett <br />V GTY HALL 2`�9�Q]� „ <br />1L( p1 � <br />o "a-"a. <br />r- '- <br />�Ti�UCTI(�� � � "' � <br />� �;�:;- =� <br />PERMIT PERMIT N�?a 1�.��.��. =.� <br />��E�'"w �9 �� L'(�A1��INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING�}� � . - �� <br />OWNER MAILAOOPESS qTY ZIP �PHONE" <br />Robert J. Christenson 10709 - 9th Dr SE Everett 98204 35SS�6676 <br />ARCHITECi OR OESIGNER MqIL ADORESS CITY ZIP z PMONE <br />Impress�on Design 2229 Jackson Everett 96203 355-3200 <br />GENERAL GONTRACTOR MAIL ADOFESS CITY ZIP PHONE LICENSE N <br />MECMANICFL CONTRACiOP MAIL FODRE55 LITY ZIP PHONE LICENSE M <br />PLUMBING GONTRACTOR IdAIL ADORESS CITY Z�p PHONE LICENSE N <br />❑ NEW C3:ADDI710N ❑ ALTERATION ❑ qEPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />57,500.00 <br />'�CFIBE WORK <br />Add family room, utility room and garage <br />Residential <br />Broadway Farms #2 <br />l0T_BLOCN_OF <br />S 100' E� TR 39 Except W x 30' <br />10709 - 9th Dr SE <br />PLUA181NG <br />10. � TYPE OF FIXTURE OR ITEM <br />1 WATERCLOSET(TOILEn <br />BATHTUB <br />1 LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DiSP. <br />DISHWASHER <br />LAUNDRY7RAY <br />1 CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF ORAINS - RAINLEADERS <br />SINK �SERVICE - BAR, ETC.1 <br />6' <br />USE ZONE <br />R-1 <br />TYPE OF CONST. <br />V-N <br />SIZE OF BLDG. <br />Addn 396 sf <br />FEE <br />SUB 70TAL S <br />PEf1MIT S <br />70TAL FEE 5 <br />EET SETPACK REAR YARD S <br />20' 20' <br />AREA VACANT SITE <br />..YES �{�.NO <br />R-3 &M 1 <br />DF STORIES 61A%. ( <br />1 <br />APPqOVALS BY <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS— <br />3.PIREHYDRANT ,-� <br />4. FIRE P40TECTION-6YS7EM <br />5.GRA�ING <br />6.DRAINAGE <br />7.ENVIRONMENTACIMPACTSTATEMENT <br />8. HEALTH DISTRICT'' <br />APPLICATION ACG. Y PLANS CHECKED BY APPR. FOR I5: <br />• c� <br />�-$G'- �. c� SG L.C. <br />- <br />�- <br />i <br />� <br />'� 1 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND URDINANCES <br />GOVERNING THIS TYPE OF WORK WIL� BE COMPLIFD 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 PROVIS�ONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNAjqRE OF f.ONTqACTOR OR FUTpORIZEO AGENT �ATE _ <br />MECHANICAL <br />N0. TYPE OF E�UIPMENT <br />AIR COND. UNITS - H.P. EA. <br />FEFRIGERATION UNITS - H.P. EA. <br />BOILERS - H.P. E.1. <br />GAS FIRED A.C. UNI75 - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.II. M EA. <br />WALL HEATERS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />j CLO7HES ORVERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />ME7AL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEA7 PUMP <br />86/16311 <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTV <br />Sl1B TOTAL <br />PERMI7 <br />TOTALFEE <br />F <br />FEE q4.53 <br />VALUA710N <br />b 7.500 <br />5 4 <br />5 • <br />5 4 <br />�HECK FEE <br />RECEIP7 NO. <br />79810 <br />FEE <br />TOTAL I I 7�55�� <br />PEFMIT VALIDATION <br />WHEN PFOPERLY VALIDATED �IN TNIS SPACE� THIS IS VOUR PERMI7 <br />� r '. 2 ' �'� � ° � '1 -- i <br />� c. ! � � <br />ADDRESS FILE <br />