Laserfiche WebLink
1 <br /> ll <br /> Me <br /> EIC;Y01 F CONSTRUCTIOP' <br /> everett PERMIT PERMIT NO. 12293 <br /> CITY HALL 259 8745 <br /> EVERETT.WA 90201 (18 COMBINATION a BUILDING MECHANICAL )U PLUMBING <br /> OWNER MAIL ADDRESS CITY IIP PHONE <br /> Ken Berg 17928 43rd Avenue Arlington 98221 659-6847 <br /> r ARCHITECT OR DESIGNER MAIL ADDRESS CRY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSER <br /> Same <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br /> PLUM01NO CONTRACTOR MAIL ADDRESS on ZIP PHONE LICENSE( <br /> CLASS OF WORK <br /> NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR [I DEMOLITION ❑ FENCE ❑SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S 58(000.00 _ <br /> DESCRIBE WORK <br /> Construct Single Family Residence <br /> PROPOSED USE OF BUILDING <br /> Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH rOUA COPIESI GGRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT 38 BLOCK_OF Valley View N2 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 VIOLATE <br /> --- -- OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> U 8 28 5 LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PFRFORMANCE OF CONSTRUCTION, <br /> JOB ADDRESS SIGNATURE OF N , TOR OR Alp NORI2p A NT GATE <br /> 2422 80th Place S.E. X <br /> PLUMBING MECHANICAL <br /> NO. _ TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> 2 WATER CLOSET(TOILM AIR COND.UNITS— H.P.EA. <br /> 1 BATHTUB — REFRIGERATION UNITS—N.P.EA. <br /> 2 LAVATORY(WASH BASIN( BOILERS—H.P.EA. <br /> SHOWER GAJ FIRED A.C.UNITS—TONNAGE EA. <br /> 1 KITCHEN SINK A DISP. 2 On FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER 2 00 WALL HEATE,IS— B.T.U. M <br /> LAUNDRYTRAY UNIT HEATERS— B.T.U. M <br /> 1 CLOTHES WASHER 2 EVAPORATIVE COOLERS <br /> 1 WATER HEATER 2 CLOTHES DRYERS 4 50 <br /> URINAL 2 VENTILATION FAN 6100 <br /> 4 150 <br /> DRINKING FOUNTAIN 1 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 $ SUB TOTAL 15 In <br /> PERMIT f PERMIT 3 _ <br /> TOTAL FEE 3 18 00 TOTAL FEE $ 15 00 <br /> SIDE YARD SETDACK STREET SETBACK REAR YARD SETBACK PLAN CHE]K NUMBER PLAN CHECK FEE <br /> 6' 201 201 FEE RECEIPT NO. <br /> 83/12293 199.55 63682 <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> R-1 XTES NO — <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> V-N R-3 1 BUILDING $58,000. 307 00 <br /> SIZE OF BLDG. NO.OF STORIES MAK.OCC.LOAD <br /> 1435 Sq. Ft. 2 5 PLUMBING 18 00 <br /> FIRE ZbNE BASEMENT FIRE SPRINKLERS MECHANICAL 15 00 <br /> REOUIR <br /> None YES No <br /> APPROVALS BY DATE OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY SE C. <br /> SEC.303 III <br /> 2.BUILDING PLANS 09 TOTAL 340 00 <br /> 3.FIRE HYDRANT O <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> 5.0 IND WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT ;Y) <br /> • B.Dpi/ NAGE — H V O U 8. 3 0805 i 3 0 7.00 Cr), <br /> 7.E%RONMEWTAL HWPACT Si ENT (�J <br /> B.N TH OISTKT;Q 1t•" <br /> APPWTION ACC.BN PL CHECKED BY APPR.FOR ISSUAB('.i,gY, R RECEIPT YOUR RECEIPT <br /> I.." � m o iiwN LC TVI ,rIK Y7U THANK YOU <br /> C -p <br /> �" ADbP2S=LC3 2 2 Ali 83 <br />