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Enema <br />CITY OF <br />evrett <br />C INSTRUCTION <br />25`?-BFtdt� PERMIT <br />PERMIT NO. 18078 <br />❑ DEMOLITION T❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CRY ZIP PHONE <br />Melum EDd Smith P.O. Box 592 Lake Stevens, WA 98258 653-2025 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />Same <br />MAR ADDRESS <br />CRY <br />ZIP <br />PHONE <br />MELUMG18OP7 <br />LICENSE <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />❑ NEW Cl ADDITION ❑ ALTERATION D REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />s 41,500.00 <br />DESCRIBE WORK <br />Single m= family residence BASIC PLAN 1152 <br />HEAT SOURCE <br />FT 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 />GOVL•RNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHf_THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PEFIMIT 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 />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATY2 O/PCONTRACTM. AUTHORIZED AGENT OR OWNER DA E <br />x <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPES) <br />13 Colby Place <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />1707 70th Pl SE <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />2 <br />WATER CLOSET (TOILET) <br />10 <br />00 <br />A'C - A(HNDLG UNITS - H P <br />2 <br />BATHTUB <br />10 <br />00 <br />REFRIGERATION UNITS - H P EA <br />2 <br />LAVATORY IWASH BASIN) <br />10 <br />OO 1, <br />BOILERS - B T U IH P <br />} <br />SHOWER <br />rh <br />oY <br />GAS FIRED A C. UNITS - B T U <br />1 <br />KITCHEN SINK A DISH. <br />S <br />OO <br />FORCED AIR SYSTEMS - B T U M EA <br />1 <br />DISHWASHER <br />5 <br />00 <br />WALL HEATERS - BTU M <br />LAUNDRY TRAY <br />UNIT HEATERS - B T U. M <br />], <br />CLOTHES WASHER <br />URINAL <br />5 <br />00 <br />1 <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />6 <br />50 <br />DRINKING FOUNTAIN <br />2 <br />VENTILATION FAN <br />9100 <br />FLOOR DRAIN <br />1 <br />RANGE HOOD <br />6 <br />50 <br />BACKFI WPREVENTERS <br />1 <br />WATER HEATER <br />6 <br />50 <br />ROOF' .DINS - RAINLEADERS <br />WOOD STOVE <br />SINK ISERVICE - BAR. ETC) <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />SUB TOTAL <br />i <br />45 <br />00 <br />SUB TOTAL <br />28 <br />50 <br />PERMIT <br />S <br />- <br />PERMIT <br />- <br />- <br />TOTAL FEE <br />f <br />45 <br />00 <br />TO LF'E'E - <br />-� B <br />S <br />FRONT SETBACK <br />201 <br />REAR SETBACK <br />20' <br />SIDE SETBACK <br />6' <br />P; AN CHECK NUMBER <br />87/17060 <br />FEEnp /,7C <br />JSuZT <br />RECEIPT NO <br />Y <br />USE ZONL <br />R-1 <br />LOT AREA <br />7730 <br />VACANT SITE <br />[WES ❑NO <br />FEES <br />ALUATIOW. - <br />FEE _ <br />BUILDING <br />ik100O Y_ <br />LI,U 362 <br />SO <br />TYPE OF COAST <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO OF DWELLING UNITS <br />1 <br />PLUMBING <br />L' bl';Ii ' <br />•'`I 45 <br />00 <br />SIZE Of BLDO <br />NO OF STORIES <br />MAX OCC LOAD, <br />MECHANICAL <br />VhvdL�I .)�.,,;1] <br />- <br />28 <br />50 <br />FIRE SPRINKLERS REOUIRED 11 YES El NO <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARGE <br />�;;', ' <br />1 3.50 <br />STATE ENERGY SURCHARGE <br />')" ""'I"I' <br />15 <br />00 <br />APPLICATION ACC BY <br />S.H. <br />_. <br />RANSCHECKEDBY <br />Be <br />AMR FOR ISSUANCE BY <br />L.C. <br />DRIVEWAY PERMIT <br />_ <br />WAI J,. Y,; <br />I.II:I 2q <br />00 <br />TOTAL <br />'.Hu." <br />454 <br />50 <br />1 PERMIT VALIDATION <br />WI/EN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT 00 <br />L�- <br />co <br />v- <br />;' <br />ADDRESS I ILE <br />