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1 01 <br />1 <br />IhPLI•erimn <br />C"'ONSTRUCTION <br />everett PERMIT PERMIT NO. 12394 <br />CITY HALL 259 0745 <br />EVERETT, WA 98201 R* COMBINATION 19 BUILDING MECHANICAL E$ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Duane Berg 2704 28th Street S.W. Everett 98204 353-6229 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Duane Berg Construction DUAMB224DA <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />R1kEW ❑ ADDITION ❑ ALTERATION O REPAIR O DEMOLITION ❑ FENCE ❑ SIGN 0 WOOD STOVEIFIREPLACE INSERT <br />1147,000.00 <br />Construct Sinale Family Residence <br />PROPGSED USE Or BUILDING <br />Single Family 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 />PERM/ S NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR NCEL THE PROVISIONS OF ANY OTHER STATE OR <br />AL L REGULATING CONSTRUCTION OR THE <br />NCE OF CON TRUCTION. <br />CONTRALTO TNDRI AGENT DAT <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPE[ <br />LOT 25 BLOCK_OF Valley View RI I <br />U 8 28 5tOE <br />_M <br />JOB ADDRESS <br />2605 Slot Place S.E. <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 />4 <br />00 <br />AIR COND. UNITS — H.P. EA. <br />1 <br />BATHTUB <br />2 <br />00 <br />REFRIGERATION UNITE — H.P. <br />2 <br />LAVATORY (WASH BASIN) <br />4 <br />00 <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />1 <br />KITCHEN SINK A DISP. <br />2 <br />n 0 <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />DO_WALL <br />HEATERS — B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS — B.T.U. M <br />1 <br />CLOTHES WASHER <br />2 <br />OQ <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />2 <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />I <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — V:OOD <br />ROOF DRAINS — RAINLEADERS <br />1METAL <br />FIREPLACE A CHIMNEY <br />7 <br />SO <br />SINK (SERVICE — BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUBTOTAL <br />f <br />18 <br />00 <br />SUBTOTAL f <br />22 <br />50 <br />PERMIT <br />f <br />PERMIT f <br />TOTAL. FEE <br />S. <br />18 <br />00 <br />TOTAL FEE f <br />22 <br />5 <br />SIDE YARD SETBACK <br />10, <br />STREET SLTBACK <br />201 <br />REAR YARD SETBACK <br />2 0 T <br />PLAN CHECK NUMBER <br />83/12394 <br />PLAN <br />175.1 FEE <br />CHECK FEE <br />RECEIPT NO. <br />AaT7n- CV70/R-1 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />X)FES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST, <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />1 <br />BUILDING <br />f 47,000. <br />269 <br />50 <br />SIZE OF BLDG. <br />716 Sq. Ft. <br />NO. OF STORIES <br />1 <br />MAX. OCC. LOAD <br />PLUMBING <br />18 <br />00 <br />FIRE ZONE <br />BASEMENT <br />None <br />FIRE SPRIIREDNKLERS <br />REQYES O <br />MECHANICAL <br />22 <br />SO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.BEEC.C. <br />. 303 Is) <br />2. BUILDING PLANS o0 <br />TOTAL <br />310 <br />00 <br />3. FIRE HYDRANT A.n <br />4. FIRE PROTECTION SYSTE <br />PERMIT VALIDATION <br />IS YO IT � <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THI1269.50 <br />E1) 18.00 _. 3 1859 <br />U N <br />R R E C E I Pt YOUR RECEIPT <br />YOU THANK YOU <br />5.GRAOINO -' U <br />, <br />DRAIN H <br />. ENVIRONME LIMPA TATEMENT <br />HEALTH)MTRRT <br />PLICATIOAI . BY <br />SIT m�STG <br />C -p <br />LAN9 CHECKED BY <br />APPR. FOR ISSUAN JI5 <br />LC IlT1!'A^!K <br />{ <br />-k► ' <br />A1 9 SEP 8 3 <br />ADD S 3 <br />