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&wrgreenCITY Of ("7NSTRUCTION tl- <br /> everett PERMIT PERMIT NQ, - 17905 <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATION © BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAR ADDRESS CITY ZIP PHONE <br /> Brad Backstrom 420 61st St Everett, WA .353-3107 <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP R(ONE <br /> M & D Builders, Inc. P.O. Box 868 Marysville, WA 98270 <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP RHONE LICENSE <br /> M & D Builders, Inc. MDBUII*151L4 <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br /> CLASS O.WORK <br /> ❑ NEW Q ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION [I BUILDING RELOCATION <br /> VALUATION OF WORK <br /> S 7200.00 <br /> OF.SCRIBE WORK <br /> Addition of deck and bedroom <br /> HEAT SOURCE <br /> ❑ ELECTRICITY ❑ OAS ❑ WOODSTOVE ❑ OTHER <br /> PROPOSFD USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Single family residence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR CORES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOTS—BLOCK _IL-of park's Ray vipw GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE 014 CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW R - ULAT G CONSTRUCTION OR <br /> ERFORMANCE OF CO STRU ION. <br /> JOB ADDRESS SIGNAT OF CONT C M�TIIOA AOE DATE <br /> 420 61st St. ! X <br /> PLUMBING -MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 1 WATER CLOSET(TOILET) 5 00 A;C-AiHNDLG UNITS-H P. <br /> BATHTUB REFRIGERATION UNITS-H.P.EA. <br /> 1 LAVATORY(WASH BASIN) S DO BOILERS-B U,H P <br /> SHOWER GAS FIRED Ab UNITS-B.T.U. <br /> KITCHEN SINK B DISP. FORCED.AIR SYSTEMS-B T.U. M EA <br /> DISHWASHER WALL HEATERS-B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS-B T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> URINAL CLOTHES DRYERS _ <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR GRAIN RANGE HOOD <br /> BACKFLOW PREVENTERS WATER HEATER <br /> ROOF DRAINS-RAINLEADERS WOOD STOVE <br /> SINK(SERVICE-BAR.ETC) METAL FIREPLACE A CHIMNEY <br /> FIREPLACE INSERT <br /> HEAT PUMP <br /> AS PIPING <br /> EXHAUSTFAN <br /> BUB TOTAL f 15 O BUB TOTAL 4 O <br /> PERMIT t __ PERMIT <br /> TA - <br /> TOLFEE f TOTALFEE 41 rQ <br /> FRONT SLTBACK REARSETBACK SIDE SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> 20 20 5 87/17905 64.35 89513 <br /> IISEZONE LOT AREA VACANT SITE <br /> R-2 7200 ❑YES C;No FEES VALUATION FEE <br /> TYPE OF CONST OCCUPANCY GROUP NO OF DWELLING UNITS BUILDING $ 7200.00 99 00 <br /> V-N ! R-3 1 PLUMBING 15 00 <br /> SIZE OF BLDG NO OF STORIES MAX OCC LOAD 4 J• I <br /> 370 1 MECHANICAL 4 SO <br /> INVESTIGATION FEEMM <br /> NOOfd13M�b5 <br /> FIRE SPRINKLERS REQUIRED YES EINO STATE BUILDING SURCHARGE PI PS i.110 1 50 <br /> STATE ENERGY SURCHARGE MEN 11.50 <br /> APPLICATION ACC BY R.ANSCHECKEDBY APPR FOGISSUANCE By <br /> DRIVEWAY PERMIT CHEQ,'.__ <br /> Be L.C. TOTAL 120 00 <br /> PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT `n <br /> M <br /> E�-- <br /> c— <br /> ADDRESS FILE <br />