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rhe Evergreen CONSTRUCTIONCITY of <br /> everett PERMIT f -� <br /> CITY HALL 2598i 15 <br /> PERMIT NO. 07487 <br /> EVERETT.WA 98201 1-9 COMBINATION ® BUILDING17�t MECHANICAL {,1 PLUMBING <br /> OMNEH <br /> MMI ADOR[SS .Ilr :p' PHONE <br /> SkyeView Homes 15316 50th Place W. Edmonds 98020 745-3661 <br /> ARCHITECT OR DESIGNER MAIL ADDAESS -- -. <br /> CITY ZIP MONS <br /> OENEMI CONTRACTOR MAIL ADDRESS — <br /> Same CITY ZIP THIONE LICE—NSE, <br /> MECHANICAL , MAIL ADDRESS SK YE VI 217 CH <br /> GCr 21P PHONE <br /> LICENSE I <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY <br /> ZIP RIONE IICEItSE <br /> CLASS OF WORK <br /> NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUAIION OF\YORK <br /> { 481000.0O <br /> DESCRIBE WORK <br /> Construct Rtnyml Single Family Residence <br /> PW 'OKD UK OF BUILDING <br /> Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP" <br /> LEGAL DESCRIP110N OF PROPERTY(SHOW BELOW OR ATTACH FOUR COPIES( PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> LOT 22 BLOCK.—OF Evergreen Ridge ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO. <br /> S 12-28-4 VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> IOD ADDRESS SIGNATUR OF CONTRACTOR 011 U 0AGENT DATE <br /> 202 79th Place <br /> PLUMBIND MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 2 WATER CLOSET OIL 4 00 AIR COND.UNITS—H,P.EA, <br /> BATHTUB REFRIGERATION UNITS—H.P.EA <br /> 2 LAVATORY IASH RAS IN 4 00 BOILERS—H.P.EA <br /> 1SH2 <br /> WER 2 00 GAS FIRED A.C. UNITS—TONNAGE EA. <br /> 1 KITCHEN SINK.A DISP. 2 00 FORCED AIR SYSTEMS—B T.U. M EA 5 00 <br /> . <br /> 1 DISHWASHER 2 OO WALL HEATERS—B.T.0M <br /> LAUNDRY TRAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HCATER URINALCLOTHES DRYERS <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN 1 AIR HANDLING UNIT— <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS 1 METAL FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE—SAFI,ETC.) --- <br /> I " <br /> I SUB TOTAL 20 00 8UB TOTAL f 1B 00 <br /> PERMIT f PE(IMIT { .' <br /> TOTAL FEE 51 201 00 TOTAL FEF. { B 00 <br /> SIDE YARD SETBACK STREET SETBACKREAR YAR SETBACK PLAN CHECK NUI..BER PLAN CHECK FEE <br /> 61 201 201 7487 FEE 90.50 RECEIPT NO <br /> ( USE ZONE LOT AREA VACANT S1TE 201 <br /> R-1 XNES ONO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> V-N R-3 1 <br /> SIZE OF BLDG NO.OF STORIESMAX OCC.LOAD BUILDING f 48,000. 18 00 <br /> 261 x401 1 PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS 2 00 <br /> . 3 yes OEOUIIRED YES O MECHANICAL 1 00 <br /> APPROVALS BY ATE OTHER <br /> 1. ENVIRONMENTAL CHECK LIST <br /> PENALTY UBC. <br /> 2. BUILDING PLANS N SEC.303(a) <br /> 3. FIRE HYDRANT O TOTAL 219 00 <br /> A. FIRE PROTE ION SYS1WM PERMIT VALIDATION <br /> 1 5. GRADING ,/ WHEN PROPERLY VALIDATED IN THIS SPACE)THIS ISYOUR <br /> pPE RMIT <br /> �B. DFIAINAPE� M 0. 3 23 02 S 1 g 1. 0 0 <br /> Ez;7. EN'1IRO@MMtP1TAL IMPACLSTATEMENT <br /> Y1�8 hEAL$i 1 ICT rrtt I- <br /> ;y_ PPLICATI N BY •fM_ANI1 CHECKED BY APPR FOR ISSUAN E BY R R.C C E I PT <br /> Y(_U R RECEIPT c) <br /> f m <br /> c <br /> V.C. <br /> , : u THANK YOU <br /> A1)D�, 'SS' jA0 1 9 alar 80 <br />