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the &,ergrecn •-°` <br />CITY OF <br />everett <br />C�INSTRUCTION <br />PERMIT <br />PERMIT NQ: -19181 <br />Cl DEMOLITION COMBINATION ❑ BUILDING ❑ MECHANICAL Cl PLUMBING ❑ SIGN <br />OWNER MAIL At)t)n6S CITY 7I1, PHONE <br />Henry Osborn 30 140th NE Marysville, WA 98270 652-0603 <br />ARCHITECT OR DESIGNER MAR ADORES; CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />Owner <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE. <br />Cl ASS OF WORK <br />Q NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />' 46,000.00 <br />DESCRIBE WORK <br />Construct frame single family residence <br />HEAT SOURCE <br />Cl ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE Of BUILDING <br />Single family residence <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 <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />TH FlfiORMANCE OF CONSTRUCTION. <br />SIG FCONTRACT )ZED AGENT. OWNER DATE <br />-H2 0 <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK _ OF <br />See Attached <br />JOB ADDRESS <br />63rd St. Sl; 1610 BBKBXKK. <br />PLUMBING <br />MECHANIC <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />2 <br />WATER CLOSET(TOILETI <br />10 <br />00 <br />AC—AMNDLG UNITS — HP <br />1 <br />BATHTUB <br />5 <br />00 <br />REFRIGERATION UNITS — H P. EA. <br />2 <br />LAVATORY (WASH BASINI <br />10 <br />00 <br />BOILERS —B.TU/H P. <br />SHOWER <br />GAS FIRED AC UNITS —8T.U. <br />1 <br />KITCHEN SINK 6 DISP. <br />5 <br />00 <br />FORCED AIR SYSTEMS — B T U. M EA <br />1 <br />DISHWASHER <br />5 <br />00 <br />WALL HEATERS —B.T.0 M <br />LAUNDRY TRAY <br />UNIT HEATERS —8TU M <br />1 <br />CLOTHES WASHER <br />5 <br />00 <br />EVAPORATIVE COOLERS <br />URINAL <br />1 <br />CLOTHES DRYERS <br />6 <br />5 0 <br />DRINKING FOUNTAIN <br />23 <br />VENTILATION FAN <br />9 <br />00 <br />FLOOR DRAIN <br />1 <br />RANGE HOOD <br />6 <br />50 <br />BACKFLOW PREVENTERS <br />1 <br />WATER HEATER <br />6 <br />50 <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC.) <br />METAL FIREPLACE a CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />OAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />S <br />40 <br />00 <br />SUB TOTAL <br />28 <br />50 <br />PERMIT <br />$ <br />PERMIT <br />TOTALFEE <br />$1 <br />4 n <br />TOTAL FEE <br />FnONT SETBACK <br />20 <br />REAFI SETBACK <br />20 <br />SIDE SETBACK <br />5 <br />PLAN CHECK NUMBER <br />87/19181 <br />FEE <br />227.18 <br />RECEIPT NO <br />93776 <br />USE ZONE <br />R-2 <br />LOTAREA <br />5060 <br />VACANT SITE <br />93YES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ 46,000 <br />3 0 8 <br />50 <br />TYPE OF CONST <br />V—N <br />OCCUPANCYGROUP <br />NO OF DWELLING UNITS <br />1 <br />PLUMBING <br />40 <br />00 <br />SIZE OF BLDO <br />1752+GAR <br />NO Of STORIES <br />2 <br />MAX OCC LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REOUIRED Q YES III NO <br />INVESTIGATION FEE Plan <br />rk Set. 3D41P1 <br />r <br />STATE BUILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />15 <br />APPLICATION ACC BY <br />S.H. <br />PLANS CHECKED BY <br />B.E. <br />APPR FOR ISSUANCE BY <br />L.C. <br />DRIVEWAY PERMIT <br />20 <br />-Da <br />00 <br />TOTAL <br />DFRYIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />f— <br />00 <br />It- <br />-M <br />It — <br />ADDRESS FILE <br />