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s <br /> �: !he L•1'ergreen , <br /> �, ; ; � - -;oNs-r�ucrior�. <br /> �v�a ��� �'ERMIT PERMITNO. 16256 <br /> CITV HALL 259�B7a5 <br /> i7 evefle�r�ri,ti9�zoj '��J �OAyI�INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> UWNE❑ MAILADDRE55 CITV ;IP PMONE �— <br /> LESSLEY i�ONSTRUCTION 18204 Bothell Everett Hwy #2 Botheil WA 98012 <br /> A5CMITEGT OR DESISNEP MAIL ADDFE55 CITY 21F PHONE <br /> GENERFL CONTRAGTOR MAIL ADDRE55 GITV ZIP PMONE LICENSE N <br /> J�me <br /> M.'NANICAL CONTRACTOR MFIL AUORE55 GTY 21P PHONE LICENSF.I <br /> PLUMBING CONiPACiOR M41L AOORE55 GITY ZIP PNONE LICENSE x <br /> CLA55 OF'NORK <br /> Ca NEIV ❑ ADDI710N ❑ ALTERATION ❑REPAIR ❑ DEMOLI�ION ❑ FENC[ ❑ SIGN ❑ WOOD S70VFJFIREPLACE INSERT <br /> n <br /> VALUATION OF WOflK <br /> 55�e�00.�� <br /> JESCPIBE WORR <br /> New sinqle familv residence <br /> PROf'OSEO USE OF BUIL�ING <br /> Si nql e famil y r�sidence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW ThIE SAME TO 8E TRUE AND <br /> LEGAL�ESCRIPiIONOFPROPEFTY�SHOVJBELO'NORATTFCMFOURGOP:ES� �ORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or 9 BLOCN_OF W1110W Creek Gl en GOVERN�NG THIS TYPE OF WORK WILL 8E COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> — OR CANCEL TNE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFO f�AANCE OF CONSTRUCTION. <br /> JOB ADORE55 SIGNATV OF NTRACTOR OR AUTMORI2E�AGENT /DATE <br /> 5131 - 15th Ave 4! X r �J �7� <br /> PlUM81NG MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> 3 WATER CLOSET(TOILE7} AIR COND.UNITS— H.P. EA. <br /> � BATH7U� 2 QQ REFRIGERATION UNITS — H.P.EA. <br /> 3 LAVATORY�WASH BASIN� ( OO BOILERS -- H.P. EA. <br /> � SHOWER 2 Q� GAS FIRED A.C. UNITS —TONNAGE EA. <br /> � KITCHEN SINK 8 DISP. 2 QQ FORCED AIR SYSTEMS— B.T.U. M EA. <br /> � DISHN/ASHER 2 QQ VJALL HEATERS— B.T.U. M <br /> LAUNDRY TRAY UNIT iiEATERS— B.T.U. M <br /> � CLOTHES WASHEF Z 00 EVAPORATIVE COOLERS <br /> � WATER HEATER Z OO � CLOTHES�RYERS 4 5O <br /> URINAL � VENTILATION FAN <br /> _ ORINKING FOUNTAIN � RANGE HOOD � <br /> FLOO(i DRAIN AIR HANDLING UNIT— C.F.PA. <br /> VACUUM dREAKERS � � STOVE—WOOD ] 5 <br /> ROOF DRAINS— RAINLEA�[RS METALfIREPLACE&CHIMNEY <br /> SINK�SERVICE — BAR, ETC.) FIREPLACEINSERT I <br /> HEAT PUMP <br /> sue rora� 24 00 sue rora� s <br /> PEPMIT 5 PERMIT 5 <br /> TOTAL FEE S 2Q OO TOTAL FEE S 5� <br /> SIDE YARD SETBACK STREET SETBACK REAF YARD SETBACK PLAN CHECK NU�dBER FLAN CHECK FEE <br /> 6� 2�� 2�� 86/ 16256 FEE hd 51 C AECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE _ <br /> R_� kEs Na FEES VALUA'lION FEE _ <br /> h <br /> TVPE CF CONST. OCCUPANCY GROUP NO. OF CWELLING UNITS <br /> V-N R-3 � BUILDING g 50 000. 2S3 OG <br /> SIZE OF BLDG. NO.GF STORIES h1AX. OCG LOAD <br /> R=1415 1?- 5 PLUMBING 24 00 <br /> FIRE ZONE BASEMENT FIRE SPRINKLEflS MECHANICAL � 9 5O <br /> REOUIRED <br /> VES NO <br /> APPROVA:S BY DATE OTMER <br /> i.ENVIRONMENTAL CHECK LIST PENALTY U.B.C. <br /> 2.BUILDING PI.ANS SEC.303(a) <br /> 3.FIflEHYDRANT �— TOTAL 326 5� <br /> 4.FIRE PROTECTION SVSTEM> PERMI7 VALIDATION <br /> S.GRAOING �-' WNEN PROPEFLY VALIDATEDQN THISISPA�F.�THIS I$YpUR�PERM�7 _� _ 1 <br /> 6.DRAINAGE �� I ��, 1 1 i ,; — � <br /> 7.ENVIRONMEN7ALIMPACTSTATEMENT � - <br /> B.HEALTHDISTRICT �_- <br /> APPLICATION ACC. BY ' ANS CHECKED BY APPR. FOR ISSUANCE BV � ' ' ' ' � � <br /> _ ' S9 �C <br /> � ADDRESS FILE <br />