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_ <br /> �1 _ <br /> U�eEre�greeri � C�n�STRUCTION <br /> CRY OF <br /> �verett PE�M�� PERMi� NO. 08� 47 <br /> GTY HALL 259�67A5 <br /> [VLRETT.VJA 9870� ❑ CUMBINATION Q aUILG�iVG ❑ MECHANICAL PLUMBING <br /> AIAIL A�URE55 <br /> GI(Y Pi' PHONE <br /> OY/NER <br /> Jeff Anderson 1712 12th Everett AaN <br /> ARCIIRECT OR OESIGNLR <br /> MM!FDORESS CIiY ZIP <br /> GENCPAL GONiPACiOR 1dAIL AD�RE55 <br /> CIiY ZIP PNONE IICENS[� <br />� Snohomish County Aome Improvement Lake Stevens 918258 PMONE uceruse. <br /> MECMANIGALCONTRAGTOR <br /> MAIL A�DflE55 CITY <br /> PLUM�ING CONiRAC70F <br /> 61PILADORE55 CITY ZIP PHONE LICENSEI <br /> CL/SS OF WORR <br /> ❑NEW ❑ADDITION ❑ALTERATION XRREPAIR ❑DEh10LIilON ❑�ENCE ❑SIGN GARAGE <br /> VALUATION OP VlORK <br /> f 4 , 000. 00 <br /> oescaio�worn <br /> Re—side vinyl Siding <br /> PROPOSED USE OF BUIL�ING <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ A�JD EXAMINED THI - <br /> �ecn�oescniPnoHOFPNove�TrisHowoeiovionnrrncHFwacoaics� PUCATION AND KNOW THE SAME TO BE TRUC AND CORFECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOV[RNING THIS <br /> �or 17 e�ce�38F � Heights TYPE OF WORK WILL BE CO��IPLIED WITN WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUNIE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISION� OF ANY OTHER STATE OR LOCAL lAW REGULATING <br /> CONSTRUCTION THE PEHFORMANCE OF CONSTR�U ETICIJ. <br /> — - SIGNAIURE � CONTR iOR�R AUTH � AGE <br /> JOO ADDRE55 X � � <br /> 1712 12th Street <br /> MECHANICAL <br /> PLUMBING FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE N� piR COND.u YP5 OH,pOAIPMENT <br /> WATER CLCSET(TOILET) <br /> REFRIGERATION UNITS—H.P. EA <br /> BFTHTUB <br /> BOILEPS—H.P.EA. <br /> LAVATORY 6'�ASH��SIN) <br /> GAS FIHED A C.UIJITS—TONNAGc EA. <br /> SNOWEfl FORCED AIR SYSTEMS—BTL. M�A. <br /> KITCHEN SINK&DISP. M <br /> bVALL H`_AiERS—6.T.U. <br /> DISHWASHER M <br /> UNIT HEATEi75—B T.U. <br /> LAUNDRYTFAY <br /> EVAPORATIVE COOLERS <br /> CLOTHES WASHER CLOTHES DRYERS <br /> WA7ER HEATER <br /> _ VENTILATION FAN <br /> URINAL pqNGE HOOD <br /> DRINKING FOUNTAIN <br /> AIR HANDLING UNIT�— GF.M. <br /> FLOOR DRAIN STOVE <br /> VACUUM�REAKERS <br /> ldETAL FIREPLACc 8 CHIMNEY <br /> RGOP DRAINS—RAWLEADERS <br /> SINK�SERVICE—BAR,EiC.) <br /> SUBTOTAL S <br /> SUB TOTAL pERMIT S <br /> PEHMIT S <br /> 70TA-. FEE S TOTALFEE S <br /> PLAN CHECK FEE <br /> SIDE YFRD SETBACK STREET�'TBNCK REAR YAFD SETBACK PLAN CHECK NUMBER FEE fiECGIPT N0. <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> L1�ES ❑NO <br /> TYPE OP CONST. OCCUPANCY GROUP NO.Of DWELLING UNITS <br /> BUILDING 54 ,000 . 00 28 00 <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC. LOAD <br /> PLUMBING _ <br /> FIRE ZONE BASEMENT FIRE SPRII:KLERS MECHANICAL <br /> REOUIRED <br /> ❑YES ❑NO <br /> APPHOVALS <br /> BY DATE OT�iER <br /> 1. ENVIRONMEN7ALCHECKLIST PENALTY U.BC. <br /> SEC.303(a) <br /> 2. BUILDING PLANS TOTAL 2 S 00 '� <br /> 3. FIRE HYORANT <br /> PERMIT VALIOATION <br /> 4. FIRE PROTEC710N SYSTEM y�/HEN PROPERLY VALIDATED(IN THIS SPACE)iH151S YOJR PERMIT <br /> S. GFADIIJG J I � 9 � O � 0. o0 • '. � <br /> Q <br /> G. �RAINAGE � <br /> L ENVIRONMENiAI IMPACT STATEMENT � <br /> B. HEALTHDISTRICT f�`.i��J2 R�CfIPT O <br /> APPUCATION ACG BY PLANS CHECKED BY APPR.FOP ISSUANCE BY ������'�I�i K Y� U <br /> - ,, ,��c s a <br /> ADDRESS FILE <br /> � <br /> „ . <br />