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the ErIT)O (F 10 11FONS'TRUCT101* <br />everett PERMIT <br />CITY HALL 2598745 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />• <br />PERMIT NO. 16653 <br />0 PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Don L. Bachofner <br />506-61Bt <br />Everett <br />98203 <br />353-3974 <br />AR NIIECT OR ESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />MECHANICAL CONTRACTOR MAIL ADDRESS CDY ZIP PHONE LICENSER <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />South County Plumbing 18632-79th Place W. Edmonds 98020 775-7377 <br />CLASS OF WORK ❑ SOIITFICPLA1MI0z <br />NEW I� ADDITION ❑O <br />ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑ WOD STOV FI C INSERT <br />3,000.0 <br />DESCRIBE WORK <br />.I.. <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />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 VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />RMA CE OF CONSTRUCTION. <br />SIGNATU F OF TRAOR CTALT IZED AGE DATE <br />x506- C/v, <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT 6 BLOCIA20D-g3 Pecks Bav View Tracks <br />JOB ADDRESS <br />PLUMBING <br />EC ICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSETITOILET) <br />AIR COND. UNITS - H.P. EA. <br />_ <br />1 <br />BATHTUB <br />00 <br />REFRIGERATION UNITS - M.P. EA. <br />LAVAT^RY(WASH BASIN) <br />BOILERS - H.P. EA, <br />SHOWER <br />GAS FINED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK f DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS - 3.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKER'1 <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE B CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />f <br />SUB TOTAL f <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />f <br />1 A <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />51 <br />STREET SETBACK <br />201 <br />REAR YARD SETBACK <br />201 <br />PUN CHECK NUMBER <br />B6/B-005 <br />PLAN <br />FEE <br />35.10 <br />CHECK FEE <br />RECEIPT NO. <br />80427 <br />USE ZONE <br />R-2 <br />LOT AREA <br />VACANT 617E <br />YES :XNO <br />FEES <br />VALUATION <br />FEE <br />Bldg. Oode SurChaY <br />1 <br />SO <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />1 <br />BUILDING <br />$3,000.00 <br />54 <br />00 <br />SIZE OF BLDG. <br />Addn. 51 S._F. <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />PLUMBING <br />15 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <br />MECHANICAL <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 11031A) <br />2. BUILDING PLANS <br />TOTAL <br />70 <br />50 <br />3. FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />5. GRADING <br />— <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IN THIS SPACEI THIS IS YOUR PERMIT (M <br />L0 <br />(Q <br />rI <br />—_ <br />S. DRAINAGE <br />_ <br />T. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />M. M. <br />PLANS CHECKED BY <br />S.G. <br />APPR. FOR ISSUANCE BY <br />L.C. <br />ADDRESS FILE <br />