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The T`II•FPLI C' NSTRUCTION <br />•.I <br />everett PERMIT <br />CITY HALL COMBINATION ❑X BUILDING !Xl MECHANICAL <br />EVERETT, WAA 998201 201 ❑X <br />PERMIT NO. 08191 <br />k_I PLUMBING <br />OWNER MAL ADDRL 55 CITY ZIP PHUNL <br />Gregg Dowell 10630 31 Dr. S. E. Everett 98204 337-3320 <br />ARCHITECT OR DESIGNER MAIL ADDRESS • 'Ty ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />I I, <br />ZIP <br />PHONE LICENSEE <br />Olin Const. <br />10605 39th Drive S.E. <br />Everett <br />98204 <br />337-4047 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE F <br />OL IN C• •240 JZ <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />CUSS OF WORK <br />MEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE — <br />VALUATION OF WORK <br />E 60,000.00 <br />Construct sin le family residence <br />9 <br />PROPOSED USE OF BUILDING <br />family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />single <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL DESCRIPTION OF PROPERTY?SHOW B LOW OR ATTACH FOUR COPIES) <br />14 4 Lakeview Sub <br />Div exca t <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />Lor eLocK._oF <br />Southern 20 as measure <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />along East <br />iine <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO. <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONST UCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />S 19-28-5 <br />- <br />SIGNATUR FCO;iIUCTOR ORA IORIZED AGENT DATE <br />JON AODRF55 <br />1706 giIX 76Ttlt1Px'xR X�C7EX Stockel3ow Rd. <br />X XSXgXXRX <br />MEC )CAL 10/6/80 <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />_ <br />FEE <br />N <br />TYPE OF EQUIPMENT <br />FEE <br />1 <br />WATER CLOSET OILET <br />AIR COND. UNITS — H P. EA. <br />j <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA <br />1 <br />LAVATORY ASH BASIN <br />BOILERS — H P. EA. <br />_ <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />— <br />1 <br />KITCHEN SINK 6 DISP. <br />1 <br />FORCED AIR SYSTEMS — B T.U. M EA <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />_ <br />l <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />1 <br />WATER HEATER <br />1 <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />1 <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDI ING UNIT — C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS— RAINLEADERS <br />METAL FIREPLACE 6 CHIMNEY <br />— <br />SINK SERVICE — BAR. ETC.) <br />I <br />00 <br />EW TOTAL <br />4 <br />Qn <br />SUB TOTAL i <br />11 <br />_ <br />PERMIT <br />•ERMIT i <br />_ <br />A FEE <br />7 <br />t4 <br />TOTAL <br />FEE F <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />SIDE YARD SETBACK SI PEET SETBACK REAII YARD SETBACK <br />61 201 <br />201 <br />80/8191 <br />FEE 103.5 RECEIPT NO <br />USE ZONE <br />LOT AREA <br />VAGItNT SITE <br />❑r:c <br />FEES <br />VALUATION <br />_. — <br />_ <br />R-1 <br />kith <br />TYPE OF CONST, <br />OCCUPANCY GROUP <br />NO. Or DWELLING UNITS <br />BUILDING <br />3 60,000. <br />20700 <br />V-N <br />R-3 <br />1 <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OOC. LOAD <br />— <br />1040 Sq. Ft. <br />1 <br />PLUMBING <br />14 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />SPRINKLERS <br />MECHANICAL <br />11 <br />00 <br />3 <br />none <br />vesilo <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />Us C <br />6EC 303 (S) <br />2 BUILDING PLANS ^'1 <br />TOTAL <br />232 <br />00 <br />3. FIRE HYDRANT w <br />4. FIRE PROTECTION SYSTfTA <br />PERMIT VALIDATION <br />pWHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IB YOUR PERMIT <br />1'OI�.00 --- 3 Q%bU �20�.00--- <br />E. GRADING <br />r <br />DRAINAGE <br />F� r <br />. R- r 1 E Tn .. I (1T C <br />ENVIRONMENTAL IMPABF6TATEMENT <br />H_EE"�' <br />B� H[ALT/i DISTRICT - <br />II <br />