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The EYeE7¢Iren <br />CITYUE OCONSTRUCTIO* <br />everett PERMIT <br />CITY HALL 2598745 <br />EVERETT, WA 98201 0 COMBINATION H BUILDING F� MECHANICAL <br />PERMIT NO. 16055 <br />FLI PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Ben Kirstein 2209 Colby Avenue Everett 98201 252-5598 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PMON! <br />GENERA) CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />Cronin Custom Homes <br />713 S.E. Everett Mall Way <br />Everett <br />98204 <br />353-6500 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />21P <br />PHONE LICENSE F <br />CRONII*2140B <br />PLUMBING CONTRACTOH <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE F <br />CLASS OF WOE '"j <br />XR NEW Cl ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />76,000.00 <br />DESCRIBE WORK <br />Construct Single Family Residence <br />PROPOSED USE OF BUILDING <br />Single Family Residenco <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 QOECIFIED 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 />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURSEQF50NTAACTOR OR AUTHORIZED GENT DATE <br />X 41 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIESI <br />1 Mountain View Div. #5 <br />LOT . BLOCK —OF <br />JOB ADDRESS <br />821 85th Street S.E. <br />PLUMBINr <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />MECHANICAL <br />NO.1 <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />_ 4 <br />00 <br />AIH COND. UNITS - H.P. EA. <br />BATHTUB <br />2 <br />00 <br />REFRIGERATION UNITS - M.P. EA <br />3 <br />LAVATORY (WASH BASIN) <br />6 <br />00 <br />BOILERS - H.P. EA. <br />1 <br />SHOWER <br />2 <br />00 <br />GAS FIRED A.0 UNITS -- TONNAGE EA. <br />KITCHEN SINK& DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />2 <br />00 <br />WALL HEATERS - B.T.U. M <br />LAUNDRY TRAY <br />2 <br />00 <br />UNIT HEATERS - B.T.U. M <br />-I <br />CLOTHES WASHER <br />2 <br />00 <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />2 <br />00 <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN _ <br />Q <br />DRINKING FOUNTAIN <br />RANGE MOOD <br />4 <br />50 <br />FLOOR DRAIN <br />AIR MANGLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE -WOOD <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPI ;E INSERT <br />HEAT PUMP <br />SUB TOTAL f <br />24 <br />00 <br />SUB TOTAL S. <br />15 <br />00 <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f <br />TOTAL FEE 21 <br />15 <br />100 <br />SIDE YARD SETBACK <br />61 <br />USE ZONE <br />R-1 <br />STREET SETBACK <br />201 <br />REAR YARD SETBACK <br />201 <br />PLAN CHECK NUMBER <br />86/16055 <br />PLAN <br />FEE Basic <br />CHECK FEE <br />RECEIPT NO. <br />LOT AREA <br />VACANT SITE <br />XXES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3--M <br />NO. OF DWELLING UNITS <br />1 <br />BURDING <br />f 76E000. <br />361 <br />00 <br />SIZE OF BLDG. <br />797 Sq. Ft. R-3 <br />NO, OF STORIES <br />1 <br />MAX.000.LOAD <br />PLUMBING <br />MECHANICAL <br />24 <br />15 <br />00 <br />00 <br />I E E <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES O <br />OTHER <br />APPROVALS <br />_ <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. JOJ (a) <br />- <br />OO <br />2. BUILDING PLANS <br />TOTAL <br />400 <br />3. FIRE HYDRANT - - <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS DACE) THIJI$ YpU[1 P`6RIAIT — 1,--1 <br />,�, II ? �I. II SS GG II ''JJ �O <br />_ n r- nT <br />I - 7 , , 11. � Yl �.. 1 % 1 � E C L_ I 1 1 4 <br />11FA HK YOU <br />'1 <br />5.GRADING <br />.DRAINAGE ..• <br />..I <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />EALTH DISTRICT <br />A,PPLICATION AC'C. BY <br />�LANS CHECKED BY <br />o <br />APPR. FOR ISSUANCE BY <br />ADDRESS' F48 0 0 1 I f E0 u G <br />