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M <br />R <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259 8745 <br />EVERETT, WA 98201 <br />F OONSTRUCTIOr' <br />PERMIT <br />❑ COMBINATION (R BUILDING MECHANICAL <br />PERMIT No. 14633 <br />11 PLUMBING <br />OWNER Contractors MAIL ADDRESS Cuv "IP PHONE <br />P.R.A. @ffKX1kK71KKdIK 1826 4th Street Marysville 98270 653-7300 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />Same PRASS182BH <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIo PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS I ZIP PHONE LICENSE A <br />X$J NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOO STOVE/FIREPLACE INSERT <br />f 75,000.00 <br />Construct Single Family Residence <br />PROPOSED USE OF 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 />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOC L LAW REGULATINGIUN OR THE <br />PER 0 M NO RUCTI <br />SIGN VR O O OR T RIZE 1 DATE c <br />X _ 0 <br />LEGAL DESCRIPTION OF PROPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />5 Mou%� ain View Div. 6 <br />LOT —BLOCK— <br />JOB ADDRESS <br />721 89th Street S.E. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER C.OSET(TOILET) <br />AIR COND. UNITS - H.P. EA. <br />1 <br />BATHTUB <br />2 <br />DO <br />REFRIGERATION UNITS - H.P. EA. <br />_ <br />3 <br />LAVATORY (WASH BASIN) <br />BOILERS - H.P. EA. <br />1 <br />SHOWER <br />2 <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />1 <br />KITCHEN SINK d DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />1 <br />DISHWASHER <br />2 <br />WALL HEATERS - B.T.U. M <br />_ <br />1 <br />LAUNDRY TRAY <br />2 <br />0 <br />UNIT HEATERS - B.T.U. M <br />1 <br />CLOTHES WASHER <br />2 <br />00 <br />EVAPORATIVE COOLERS <br />1 <br />WATER HEATER <br />2 <br />00 <br />1 <br />CLOTHES DRYERS <br />_ <br />URINAL <br />3 <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />1 <br />RANGE HOOD <br />4 <br />SO <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />I <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR. ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />BUS TOTAL f <br />24 <br />00 <br />SUB TOTAL f <br />25 <br />3D__ <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f <br />24 <br />00 <br />TOTAL FEE f <br />SIDE YARD SETBACK <br />61 <br />STREET SETBACK <br />201 <br />REAR YARD SETBACK <br />201 <br />PLAN CHECK NUMBER <br />85/14633 <br />PLAN <br />FEE 222.9 <br />CHECK FEE <br />RECEIPT NO <br />75919 <br />USE ZONE <br />R-1 <br />LOT AREA <br />VACANT SITE <br />)WB [!NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF COMET. <br />V-N <br />OCCUPANCY GROUP <br />R-3-M <br />NO. OF DWELLING UNITS <br />1 <br />BUILDING <br />f 75,000. <br />358 <br />00 <br />SIZ14§%BLOG. Ft <br />-A1332 Sq. Ft. <br />No OF STORIES <br />1 <br />MAX. OCC. LOAD <br />5 <br />PLUMBING <br />24 <br />00 <br />FIRE ZONE <br />BAF'<MENT <br />None <br />FIRE SPRINKLERS <br />REOLDRED 0 <br />MECHANICAL <br />25 <br />50 <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (A) <br />2. BUILDING PLANS <br />TOTAL <br />407 <br />50 <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION r�77 <br />WHEN PROPERLY VALIiSATE-0IIN THIS SPACE) THIS IS v,OyR PERMIT (`r� <br />5. GRADING <br />5. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT ..I <br />APPLICATION ACC. BY <br />EB <br />PLANS CHECKED BY <br />HWM <br />AFIRE. FOR ISSUANCE BY <br />LC <br />z <br />0 <br />'-1 <br />C) <br />m <br />ADDRESS FILE <br />