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"e rONSTRUCTION n p <br />everett PERMIT PERMIT NQ: - q 17947 <br />a59-kBDtl <br />❑ DEMOLITION ❑ COMBINATION :Q BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP MIDNE <br />Melum & Smith F.O. Box 592 LK Stevens 98258 653-2025 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GCNERAL CONTRACTOR MAIL ADPRESS CITY ZIP MIONE LICENSE <br />Owner MELUMG18OP7 <br />40A;4wLc NTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IT <br />MUMBINOCONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />CLASS OF WORK <br />9 NEW ❑ ADDITION ❑ ALTERA T ION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />! 41500.00 <br />DESCRIBE WORK <br />New Single family residence <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAB ❑ WOOOSTOVE ❑ OTHER <br />PROPOSED USE Of BUILDING <br />Single family KKKUKKKK 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 />VI01 ATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW RFCiIgATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATDR F .ONTRACTO UTIIORIIED AGENT. OR OWNER ATE /' <br />)( ALI AT <br />LEGAL DESCRIPTION OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIESI <br />LOT —2. BLOCK _ OF Colby Pl. <br />JOB ADDRESS <br />1810 70th Pl. SE <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 />00 <br />A/C - A/HNOLG UNITS - H P <br />2 <br />BATHTUB <br />10 <br />00 <br />REFRIGERATION UNITS - HP EA <br />2 <br />LAVATORY ( WASH BASINI <br />10 <br />0O <br />BOILERS - B T U /H P <br />SHOWER <br />GAS FIRED AC UNITS - BTU <br />KITCHEN SINK S DISP. <br />5 <br />00 <br />FORCED AIR SYSTEMS - O T U M EA <br />DISHWASHER <br />5 <br />WALL HEATERS - B T U M <br />LAUNDRY TRAY <br />UNIT HEATERS - B T U M <br />CLOTHES WASHER <br />5 <br />EVAPORATIVE COOLERS <br />URINAL <br />I <br />CLOTHES DRYERS <br />6 <br />50 <br />DRINKING FOUNTAIN <br />2 <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 />ROOF DRAINS -- RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR. ETC) <br />METAL FIREPLACE 6 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EKHAUSTFAN <br />SUBTOTAL <br />! <br />45 <br />on <br />SUBTOTAL <br />PERMIT <br />! <br />PERMIT <br />TOTAL FEE <br />! <br />4 r <br />TOTALFEE <br />FRONT SETBACK <br />20 <br />REAR SETBACK <br />20 <br />SIDE SETBACK <br />6 <br />PLAN CHECK NUMBER <br />87/17060 <br />FEE <br />Basic <br />RECEIPT NO <br />USEZONE <br />A-1 <br />LOT AREA <br />8400 <br />VACANT SITE <br />AYES ❑NO <br />FEES <br />YI N'- <br />I" ' <br />BUILDING <br />TYPE OF CONST <br />OCCUPANCY GROUR <br />NO OF OWEL. L ING UNITS <br />1 <br />PLUMBING <br />CLOG $161.50 <br />SIZE OF BLDO <br />1636 <br />NO Of STORIES <br />1 <br />MAX OCC LOAD <br />MECHANICAL <br />TI <br />.0 <br />IRE SPRINKLERS REQUIRED DYES NO <br />INVESTIGATION FEE <br />F SW M(R) 4 <br />. S0 <br />STATE BUILDING SURCHARGE <br />u <br />I.l <br />STATE ENERGY SURCHARGE <br />NQQj]lJj :G'( <br />15,00 <br />APPLICATIONACC BY <br />M.M. <br />PLANSCHECKEDBY <br />L C <br />APPR FOR ISSUANCE By <br />L.C. <br />DRIVEWAY PERMIT <br />H <br />T <br />20100 <br />TOTAL <br />SWER 5' <br />1.00 472150 <br />WHEN PROPERLY VALIDATED BN T*A'pACE) 3�'�Ur YI}OR PERMIT <br />L� <br />1111:0- <br />Qi <br />LL` <br />l— <br />AUDHESS FILE <br />