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the Llrr <br /> c�T" 0 4000NSTRUCTIOib <br /> (" I <br /> everett PERMIT PERMIT NO. 13036 <br /> CITY HALL 25987A5 <br /> EVERETT.VJA 96101 [X] COMBINATION LX] BUILDING MECHANICAL S PLUMBING <br /> OWNER MAIL ADDRESS CITI JiP PHONE <br /> Dave Smith 104 79th Place S.E. Everett 98203 353-643') <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY 21P PHONE <br /> GENERAL CONTRACTOR MAIL AGGRESS CITY ZIP PHONE LICENSE A <br /> Everett Builders Inc. 5606 Evergreen Way Everett 98203 353-7161 <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br /> EV ER EB *301PH <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br /> CLASS OF WORK 13yy/. <br /> T��. <br /> NEW DDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S 10,900.00 <br /> DESCRIBE WORK <br /> 20' x 16' Addition to existing residence <br /> PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Single Family Residence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT 14 DLocK_oF Evergreen Ridge WOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> HETHER SPECIFIED H REN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL T'1E PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONST UCTION. <br /> JOB ADDRESS SIGN T E OF CONT RAC R OR A T RIZ D A ENT GATE <br /> 104 79th Place S.E. X 316/84 <br /> PLUMBING MECHANICAL <br /> NO, TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND.UNITS-H.P.EA. <br /> BATHTUB REFRIGERATION UNITS- H.P.EA. <br /> 1 <br /> LAVATORY(WASH BASIN) 2. 00BOILERS- H.P.EA. <br /> SHOWER GAS FIRED A.C.UNITS- TONNAGE EA. <br /> KITCHEN SINK A DISP. FORCED AIR SYSTEMS- B.T.U. M EA. <br /> DISHWASMEfl WALL HEATERS-B.T.U. M <br /> 1 LAUNDRY TRAY 2 00 UNIT HEATERS- B.T.U. M <br /> 1 CLOTHES WASHER 2 00 EVAPORATIVE COOLERS <br /> 1 WATER HEATER 2 00 1 CLOTHES DRYERS 4 50 <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE A CHIMNEY <br /> SINK(SERVICE — BAR,ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL f BUB TOTAL f 4 150 <br /> PERMIT f PERMIT f <br /> TOTAL FEE f 10 OO TOTAL FEE f 4 150 <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> 6' 20' 20' 84/13036 FEE 56.23 RECEIPT NO, <br /> 67SG7 <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> R-1 YES0 <br /> IYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> V-N R-3 1 BUILDING 110 900. 86 50 <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC.LOAD <br /> in on <br /> add'n 320 Sq. Ft. 1 PLUMBING <br /> FIRE ZONE BASEMENT IRE—SPRINKLERS MECHANICAL 4 50 <br /> REOVES XXNO <br /> APPROVALS BY DATE OTHER <br /> 1.ENVIRONMEFITAL CHECK LIST PENALTY U.B.C. <br /> SEC.303 1&1 _ <br /> 2.BUILDING PLANS "O TOTAL l01 00 <br /> 3.FIRE HYDRANT ,O <br /> t. bq ( PERMITVALIDATIONFIRE PROTECTION SYSTEWVUENURpUR-Y L1JJTED TIN TMIR11�f 1THIIST?Jt P5Rj <br /> IL <br /> &GRADING <br /> q DRAINAGE (� <br /> MO <br /> ,"NVIRONMENTAL IMPACTWATEMENT _1 `I n n ^r I P� � <br /> EALTH DISTRI" II-CF-APT. R l..L <br /> LICATION`AO" ;By .PLANS CHECKED BY APPR.FOR ISSUANCE BY U i.I-V4 K YOU <br /> 0o SIG In V9 HWM LC <br /> a rn <br /> 84 <br /> ADDRESS FILE <br />