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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />CC ASTRUCTIOiN <br />PERMIT <br />❑x COMBINATION EXI BUILDING N MECHANICAL <br />PERMIT NO. 08204 <br />R3 PLUMBING <br />OWNER MAIL ADURLSS CITI ZIP PHONE <br />Wayne Akana 8617 8th Avenue West Everett 355-4808 <br />ARCHITECT OR DLSIGNER <br />MAIL ADDRESS CITY ZIP PHONE <br />AIUDORE65 CITY <br />982b'4 353-9'700 <br />°�fSiijiRs Oehler 9210 >"vergreen Way <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F <br />CLASS OF WORN <br />WNEW ❑ADD1110N ❑ALTERA710N ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN OGARAGE <br />VALUATION OF WORK <br />S 47,500.00 <br />construct single family residence <br />PROPOSED USE OF BUILDING <br />CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />single family residence <br />I HEREBY <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />LEGAL LEGAL DESCRIPTION OF PRGPERTYISHOW BELOW OR ATTACH FOURCOPIESI <br />21 Mountain View <br />N4 <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />LOT BLaK_OF <br />HEREIN OR NOT. THE GRANTING OF A PESMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAVI REGULATING <br />L 18-28-5 <br />C RUCTION ORTHEPERFORMANCE OFCON,3TRUCTIOW <br />SIG, TU OF CON TMCT ROTTHORRED ENT DATE <br />JOB ADDRESS <br />X / 1 9XIIIII 10/2 <br />814 91st Place S.E. <br />i <br />MECHANICAL e <br />PLUMBING <br />FEE <br />N0. TYPE OF EQUIPMENT FEE <br />NO. TYPE OF FIXTURE OR ITEM <br />AIR COND. UNITS — H.P EA. <br />2 WATER CLOSET OILET <br />REFRIGERATION UNITS — H.P. EA <br />BATHTUB <br />LAVATORY ASH BASIN <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS —TONNAGE EA. <br />SHOWER <br />1 <br />FORCED AIR SYSTEMS — B.T U. M EA. 5 <br />110— <br />1 <br />KITCHEN SINK b DISP <br />WALL HEATERS — B T.0. M <br />1 <br />DISHWASHER <br />UNIT HEATERS —8T.0 M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />CLOTHES WASHER <br />CLOTHES DRYERS <br />WATER HEATER <br />VENTILATION FAN <br />40— <br />URINAL <br />RANGE HOOD <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT — C.F M <br />FLOOR DRAIN <br />STOVE <br />VACUUM BREAKERS <br />METAL FIREPLACE b CHIMNEY <br />RDOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC <br />SUB TOTAL ! <br />! <br />BUB TOTAL 18 00 <br />! <br />PERMIT <br />PERMIT <br />TOTAL FEE ! <br />TOT FEE ! <br />STREET SETBACK REAR YARDS <br />PUN <br />CHECK NUMBER PLAN CHECK FR <br />SIDE YARD SETBACK <br />201 gx <br />FEE ECEIPT NO <br />80/8204 90.5 50262 <br />61 201 <br />USE ZONE LOT AREA VACANT SITE <br />JYS ONO <br />FEES <br />VALUATION <br />FEE <br />R-1 <br />TYPE OF CONST OCCUPANCY GROUP NO. OF DWELLING UNITS <br />V—N R-3 <br />1 <br />BUILDING <br />$47,500. <br />181 <br />00 <br />SIZE OF BLDG NO .`F STORIES MAX OCC LOAD <br />PLUMBING <br />18 <br />00 <br />34'x48' 1 <br />FIRE ZONE BASEMENT pEOUIR SPRINKLERS <br />EC9t <br />MECHANICAL <br />13 <br />00 <br />3 none IIYES <br />0v0 <br />APPROVALS BY DATE <br />OTHER <br />_ <br />I. ENVIRONMENTAL CHECK LIST <br />PENALTY SEC 3031B1 <br />2. BUILDING PLANS m <br />TOTAL 212 00 <br />9. FIAF. HYDRANT <br />4. FIRE PIIOTECTION SYSt A <br />PERMIT VALIDATION <br />RLY VALIDATED (IN THIS SPACE) THIS <br />5, GRADING <br />I <br />aIIN'PRO <br />3 JJ �U�PERMITI <br />---G. DRAINAGE <br />N <br />7. ENVIRONMENTAL IMPACLSTATEMENT <br />00 <br />B HEALTH GIST ICT um <br />` ,I�� _ <br />• I 7 .• L I. I Ip1T CD <br />APPLICATION Act BY i _ LANE CHECKED BY APPR. FOR ISSUANCE BY <br />i <br />AI• �� I ` ( J <br />1 <br />c= I V.C. <br />r <br />I:. <br />- I ICI S 1) <br />