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3 <br />CONSTRUCTION <br />everett <br />PERMIT <br />PEPWIT NO.06284 <br />LVLhL1 T. % •III. I Ll <br />COMBINATION X% BUILDING MECHANICAL <br />PLUMBING <br />CANER <br />-- '. <br />Inil6 <br />David Burgen <br />1026 <br />84th ST. S.W. <br />ARCHITECT OR DESIGNER <br />MAIL ADVAt CH, <br />]m --._.. - <br />IMONE <br />MAIL ADDRLSS LI1♦ <br />GENERAL CONTRACTOR <br />ZIP <br />PHONE LCENSE <br />C. & W. Builders <br />Inc. 9804 Chapel Jill Rd. 334-4481 <br />CW <br />BU II *231J6 <br />MECHANICAL CONTRACTOR <br />MAIL MILIM SS CRY <br />LIP <br />PHONL LICENSE <br />TOR L•ML ADDRf SS CITY ZIP <br />❑NEW XXODITION ❑ALTERATION I.)REPAIR []DEMOLITION ❑FENCE LISIGN ❑GARAGE <br />VALUATION OF WORK <br />IF 11,800.00 <br />DESCRIBE WORK <br />Build 14'xl4' addition -roof to cover patio <br />PROPOSED USE Of BUILDING <br />single family residence <br />I HEREBY CERTIFY THAT I HAVE REAM AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE FAM;: 10 BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND O,IDINANCES 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 />VISIONS OF ANY OTHER STATE 'TR LOCAL LAW REGULATING <br />CONST )CTION OR TH ERFGRMANCE OF CONSTRUCTION. <br />GIGNAI 1PI •;iNACTGR HORIl 4.HI DATE <br />X 6/27/79 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH 'OUR WPILs -- <br />44 Cascade Mt. View Tract <br />LOT BIOCK_OF <br />.K)B AOURL59 � � <br />1026 84th Street S.W. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND UNITS — H P EA. <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — H P EA <br />_ <br />_ <br />SHOWER <br />(AS TIRED AC UNITS — TONNAGE. PA <br />KITCHEN SINK b DISP <br />_ <br />FORCE D AIR SYSTEMS — B T U M EA <br />DISHWAS_HE - <br />WALL HEATERS — B TU M <br />LAUNDRY TRAY <br />UNIT HEATERS — 0 T U. M <br />CLOTHES W! ;HER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />EIANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C F M <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE IS CHIMNEY <br />_ <br />SINK (SERVICE — BAR. ETC) <br />SUB TOTAL <br />SUB TOTAL S <br />PERMIT S <br />PERMIT <br />TOTAL FEE S <br />TOTAL <br />FEE <br />SIDE YARD SETBACK <br />6' <br />STREET SETBACK <br />20' <br />REAR YARD SETBACK <br />20' <br />PLAN CHECK NUMBER <br />79 424 <br />PLAN CHECK <br />FEE <br />30.00 <br />FEE <br />RECEIPT NO <br />40809 <br />USE ZONE <br />LOT AREA <br />9400 Sq. <br />VACANT SITE <br />tYES XXO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONSI <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO OF DWELLING UNITS <br />1 <br />BUILDING <br />$11 F 800. <br />60 <br />00 <br />SIZE OF BLDG <br />4'xl4' add. <br />NO OF STORIES <br />1 <br />MAX OCC LOAD <br />PLUMBING <br />FIRE ZONE <br />3 <br />BASEMENT <br />I none <br />FIRE SPRINKLERS <br />H;EOUIRE4 <br />[;YES I46 <br />MECHANICAL <br />— <br />— <br />APPROJALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECK LIST <br />PE14ALTY <br />U B C <br />SEC. 303 (a) <br />2, BUILDING PLANS <br />TOTAL <br />1 <br />60 <br />00 <br />3, FIRE HYDRANT <br />4. FIRE PROTEGE ION SYSTEM <br />5. GRADING <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED UN THIS !!PAC! I THIS IS YOUR PERMIT <br />a 6 8 I 0/ O. O O -0,* 1 <br />C <br />O"J <br />N <br />YOLL��U/LR RRyECEIPT`c_) <br />r!`IfANS� . I U <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />V.C. <br />APPR. FOH ISSUANLE BY <br />ADDRESS FILE <br />11JA19 <br />