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T <br />fl:IT fl'll <br />;O�VSTRUCTIoro <br />everett <br />PERMIT PERMIT NO. 13697 <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 © COMBINATION EN BUILDING U MECHANICAL X. PLUMBING <br />OWNER <br />MAIL ADDRESS CITY ZIP PHONE <br />Jay's Builders P.O. Box 1051 Everett 98206 259-7070 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP PHONE LICENSE, <br />Same <br />JAYSBR193RA <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP PHONE LICENSE 8 <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />CLASS OF WORK <br />SXNEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑ DEMOLITION ❑FENCE [I SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />VALUATION OF WORK <br />f 71,000.00 <br />DESCRIBE WORK <br />Construct Single Family <br />Residence — <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />= <br />Single Family Residence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTAL.A FOUR COPIES, <br />CnRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />CT <br />19 Valley View <br />L., VERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />rn <br />LOT -BLOCK -OF <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />— <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />'a T <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />.H-4 <br />U 8 28 <br />5 <br />PERFORMANCE OF ON TRUCTION. <br />n m <br />JOB ADDRESS <br />SIONA OFyB//T TACT O ORRED AGENT DATE <br />C O <br />2518 Blot Place S.E. <br />X �✓ <br />Tn 5 <br />-1 c <br />PLUMBING <br />MECH ICAL <br />o <br />NO. <br />TYPE OF FIXTURE OR i_T_E_M_____F <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />s -zH <br />2 <br />WATER CLOSET (TOILET) <br />4 <br />00 <br />AIR CONK UNITS - M.P. EA. <br />En <br />1 <br />BATHTUB <br />2 <br />00 <br />REFRIGEIIATION UNITS - H.P. EA. <br />C ti <br />2 <br />LAVATORY (WASH BASIN) <br />00 <br />BOILERS - H.P. EA. <br />_ <br />1 <br />SHOWER <br />_4 <br />2 <br />00 <br />OAS FIRED A.O. UNITS - TONNAGE EA. <br />KITCHEN SINK& DISP. <br />2 <br />00 <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />• <br />_ <br />DISHWASHER <br />2 <br />0C <br />WALL HEATERS - B.T.U. M <br />oT <br />"n <br />LAUNDRYTRAY <br />2 <br />00 <br />UNIT HEATERS -B.T.U. M <br />-1 FFF»1 <br />CLOTHES WASHER <br />2 <br />00 <br />EVAPORATIVE COOLERS <br />7zn N <br />WATER HEATER <br />— <br />CLOTHES URYERS <br />URINAL <br />2 <br />VENTILATION F ,N <br />m <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />A <br />rn <br />N <br />tr <br />- <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />P1 <br />VACUUM BREAKERS <br />STOVE - WOOD <br />.� r <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />A <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />= <br />HEAT PUMP <br />> <br />-4 <br />S <br />Ln <br />N <br />SUB TOTAL <br />f <br />SUB TOTAL <br />qAG- <br />=O <br />PERMIT <br />f <br />PERMIT f <br />_ <br />,..I <br />TOTAL FEE <br />f <br />20 <br />00 <br />TOTAL <br />FEE f 5 U <br />m <br />TIDE YARD SETBACK <br />PLAN CHECK FEE <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />6' <br />20' <br />20' <br />84/13697 <br />FIE E 224.90 71095ECEIPT NO. <br />LOT AREA <br />VACANT SITE <br />FEES <br />USE ZONE <br />VALUATION FEE <br />R-1 <br />XXES NO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO, OF DWELLING UNITS <br />BUILDING <br />R-3, M <br />1 <br />f 71,000. 346 00 <br />�L EQEgV-N <br />q, <br />NO. OF STORIES <br />MAX. OCC7LOA0 <br />R-341877E Ft. <br />PLUMBING <br />20 00 <br />FIRE ZONE BASEMENT <br />FIRE SPRINKLERS <br />MECHANICAL <br />15 <br />00 <br />REOUIRED <br />YES XNO <br />APPROVALS <br />OTHER <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />Us C. <br />SEC. 303 (a) <br />38E100 <br />2. BUILDING PLANS <br />3, FIRE HYDRANT <br />TOTAL <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION �j� <br />V�HEN PROhER1(Y VALIDATEOIIf{rT+'S r4PACL) THIJ.Ig YOU%1. yylcq►llT <br />''{{ `JS <br />5. GRADING_ <br />)) �J �J <br />B. DRAINA3E <br />ILD <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />(Yj <br />G. HEALTH DISTRICT ' <br />I <br />APPLICATION ACC. BY PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />II <br />EB HWM <br />LC <br />� � i �,•., a �� _, .. <br />_ � <br />u l <br />ADDRESS FILE <br />