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n �i��E;`��RY`ok,._ � <br /> , , .. . <br /> # SONSTRUGTIC,�i� � <br /> '�V1 �'et� P�R� �� PeRMiT n�o. 16254 <br /> CITY HALL 259�87d5 <br /> t7 —�EB�T'���i �� 01 ���BINATION ❑ BUILDING ❑ PdF.Ci1ANICAL ❑ PLUMBING <br /> OWNER � MFII 4D�RESS CRY ��p PMONE <br /> Lessley Constru�tion 18204 Hothell Everett Highway #2 Bothell 98013 481-8866 <br /> ARCHITECT OF OESIGNER MAIL ADDRESS LITY ZIP PHONE <br /> Impression Design Everett 35.ri-320U <br /> GENeRAL CONTRACTOF MAIL AppFE55 CITV ZIP PHONE LICENSE� <br /> Lessley Construction LESSLI*210PK <br /> MECHANICAL CONTFACTOF A'AIL AODHESS CITV ZIP PHONE LICENSE N <br /> Same <br /> PLUd191NG CONTRAGTOR MFII ApDPS:�: CITY ZIP PHONE LICENSE I <br /> Robinson Plumb:.ng <br /> GLA55 OF R�pqN �� <br /> Ly�P1EW ❑ ADDITION ❑ ALTEFATION �]REPAIP. O DENO�ITION O t'F.MCE ❑ SIGN ❑ WOOD S70VEIFIREPLACE INSERT <br /> VALUA'lION OF W �RN � <br /> SS����O <br /> DESCRIBE WOfl6 - <br /> Single family residence, plar 1249 Basic <br /> PROPOSEO USC OF 9�IILDING <br /> Single family residence I HEREBY CERT�FY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AIJD KNOW THE SAME TO BE TRUE AND <br /> IEGAL OESGflIV710N OF PPOPERTY(SHOW BELOW OR qTTACM FOOR COPiE;{ CORRECT. ALL PROVISIONS OF LAN/S AND ORDINANCES <br /> �or 10 BLOCN_OF Willow Creek Glen GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESIiMETO GIVE AUTHORITYTO VIOLATE <br /> OR CANCEL THF PHOVISIONS OF AIJY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONS'fRUCTION OR THE <br /> PERFORMANCE OF CONSTPUCTION. <br /> JOB ADDRE55 SIGNqTURE 0 GOy i R OR FUTHORIZED AGENT DATE <br /> 5130 - 15th Ave W X c �y��' � d'7/8� <br /> 4 <br /> PLUMBING ME�ICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE DF EOUIaMENT FEE <br /> 2 WATERCLOSET(TOILET) �� AIR COND.UNI75— H.P. EA. <br /> 2 BATHTUB 4 i� REFRIGERATION UNITS — H.P. E.. <br /> � LAVATORY�WA;H BASIN) 4 � BOILERS — H.P. EA. <br /> SHOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> 1 KITrHEN SINK 8 DISP. Z p FORCED AIR SYSTEMS— B.T.U. M EA. <br /> 1 DISHWAS�ER Z Q WALL HFATERS— B.T.U. M <br /> LP�":�RYTRAY UNIT HEATERS— B.T.U. M <br /> 1 CL�rHES WASHER 2 p EVAPORATIVE COOLERS <br /> 1 WATER HEA7ER 2 p 1 CLOTHES DRYERS q � <br /> URINAL Z VENTILATION FAN 6 OO <br /> ORINKING FOUNTAIN 1 RANGE HOOD 4 SO <br /> FLOOR DPAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS S70VE—WOOD <br /> ROOF ORAINS— RAINLEADERS ]. METAL FIREPLACE 8 CHIMNEY <br /> 7 50 <br /> SINK(SERVICE— BAF, ETC.) FIREPLACE INSER"f <br /> HEAT PUMP <br /> SUB TOTAL a ZQ p SUB TOTAL S 22 SO <br /> PEHMIT 5 — — PERMIT S — <br /> TOTAL FEE S ?!1 Qp 70TAL FEE E 22 SO <br /> SIDE YARD SETBACK STREET SETBACK REAR YAFD SETBACK PLNN CNFCK NUMBER PLAN CHECK FEE <br /> 6� 20� 20' 86/1G254 FEE gaSiC RECcIPT N0. <br /> USE ZONE LOT AREA VACANT SITE <br /> R-1 X�ES . -.NO PEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> V-N R-3 1 <br /> _ BUILDING S$Q�QQQ 283 �� <br /> SI7RE OF 6lDC� NO.OF STORIES MA%.OCC. LOAO — <br /> 1L4G 1 PLUMBING ZO OO <br /> _ M = d40 <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL 22 SO <br /> REOUIFED <br /> :.�.YES : NO <br /> APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST U.e.•^, <br /> PEYALTY SEC.3G3 jal <br /> 2.BUIL�ING PLANS — <br /> J.FIREHYDRANT ;�� TOTAL 325 SO <br /> a.FIRE PROTECTION SYST2M PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIOATED(IN THIS SPAGE)THISf15'yJ 9 P^���qqq�(p�IT <br /> ��A.�RAINAGE _,.� � � i � � /. C S.��/ � <br /> 7.ENVIRONMENTALIMPAGTS7ATEMENT <br /> _' � <br /> F§.HEALTNDISTRIGT ' . ._ <br /> � .. . <br /> C AP?LICA710N ACC.BY PLANS CHECKED BY APPR. FOR ISSUAYCE BY � � � - � �- � � � � <br /> C` .. � <br /> M.M�.� ; � STG L.C. � • � �� <br /> _ . _ I <br /> ` <br /> � ADDRESS FILE � � <br />