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the El,cEgreen <br />CITY OF <br />everett <br />259-8745 <br />CINSTRUCTION <br />PERMIT <br />PERMIT NO. 17862 <br />O DEMOLITION CR COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Melum & Smith P.O. Box 592 Lake Stevens 98058 653-2025 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAR ADDRESS <br />CITY ZIP PHONE <br />LICENSE <br />Melum & Smith <br />Same as above <br />MELUMG18OP7 <br />MECHANICAL CONTRACTOR <br />MAR ADDRESS <br />City ZIP PHONE <br />LICENSE <br />CONTRACTOR MAIL ADDRESS CTV ZIP PHONE LICENSF- <br />CLASS OF WORK <br />® NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S 41,500 <br />New single family residence, Basic Plan 1152 <br />HEATSOURCE <br />❑ ELECTRICITY ❑ GAB ❑ 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 P•' COMPLIED WITH <br />WHETHER SPECIFIED HEREIN CH 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 CON,IAUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />St Of CONTRACTOR AUTHORIZED GENT, OR OWNER ATE <br />XGNATO �u 3 �C7 r <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT 4 BLOCK _ of Colby Place <br />JOB ADDRESS <br />1726 - 70th Place sr <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />2 <br />WATER CLOSET (TOILET) <br />1 <br />QO <br />A/C - A-HNDLG UNITS - H P <br />2 <br />BATHTUB <br />id <br />00 <br />REFRIGERATION UNITS - H P EA <br />2 <br />LAVATORY (WASH BASIN) <br />1C <br />00 <br />BOILERS - B T U ,H P <br />SHOWER <br />GAS FIRED A C UNITS - a F U <br />1 <br />KITCHEN SINK S DISP <br />E <br />00 <br />FORCED AIR SYSTEMS - B T U M EA <br />1 <br />DISHWASHER <br />OQ <br />WALL HEATERS -- B T U M <br />LAJNDRY TRAY <br />UNIT HEATERS - B T U M <br />1 <br />CLOTHES WASHER <br />00 <br />EVAPORATIVE COOLERS <br />URINAL <br />I <br />CLOTHES DRYERS <br />E <br />SO <br />DRINKING FOUNTAIN <br />2 <br />VENTILATION FAN <br />S <br />00 <br />FLOOR DRAIN <br />1 <br />RANGE 1400D <br />50 <br />BACKFLOWPREVENTERS <br />1 <br />WATER HEATER <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 />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL <br />f 45 <br />QO <br />SUBTOTAL <br />2 <br />SO <br />PERMIT <br />f <br />-- <br />PERMIT <br />-- <br />TOTAL FEE <br />f 41 <br />00 <br />TOTALFEE <br />2 <br />SO <br />FRONT SETBACK <br />201 <br />BEAN SETGAEA SIDE <br />201 <br />SETBACK <br />61 <br />PLAN CHECK NUMBER <br />87/17862 <br />FEE <br />0 BASI <br />E 1 <br />RECEIPT NO <br />USE ZONE <br />R-1 <br />LOT AREA VACANT <br />R044 7033 <br />SITE <br />WYES ONO <br />FEES <br />10 <br />E <br />BUILDING <br />* 112®2 <br />362 <br />50 <br />TYPE OF CONST <br />SF <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />1 <br />PLUMBING <br />LDG $36 <br />'50 45 <br />00 <br />SIZE OF PUTS <br />1152 + 484 <br />NO OF STORIES <br />1 <br />MAX OCC LOAD <br />MECHANICAL <br />F ERG <br />MECH $2 <br />.568.50 1 <br />FIRE SPRINKLERS REQUIRED QVIES ONO <br />INVESTIGATION FEE <br />L' &WfbA(e) i <br />'50 <br />STATE BUILDING SURCHARGE <br />DRWI $2 <br />1.00 1 <br />50 <br />STATE ENERGY SURCHARGE <br />000026066 <br />15 <br />00 <br />APPICANONACC BY <br />SH <br />PLANS CHECKED BY <br />Be <br />APPR FOR ISSUANCE flV <br />L.C. <br />DRIVEWAY PERMIT <br />D II 9[7 <br />.DD 20 <br />00 <br />TOTAL <br />ll'71-5 bS5 <br />.D1J 472 <br />50 <br />PERMIT VALIDATION <br />- <br />WHEN PROPERLY VALIDATED (IN *M WACEI THFIS YDUR PERMIT <br />CH CK ai482.r0 CV <br />CD <br />00 <br />ADDRESS FILL <br />