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1986, 08-05 Permit: 00012461 Residence w/GarageSIGNATURE OF OWNER OR AGENT DATE APPLICATION JOB ADDRESS S ADAMS RD °""""' ' VICTOR W ^~"^"""' S ADAMS RD �'``' ‘LE ""WA Z'"�;9037 ^—�"^~`' VICTOR W / v11.1 OK W / , rEs-'5' S ADAM RD pF1,,,^`/".� "`'^8 99837 ',.'769-926-2776 LICENSE*: °="/"~°="= ^"="""' ,',,' = ZIP: $15.00 ~zsp=" 0610 """""8�� '°"""=`""' ��"`~' l300 LOT ���c" oJ� "'"^` [t°TrAr. ADD `°""~' 1:7-1,?. -"" 5 1 S 2 ""° 550D 81+001 kESIDEN[ """°"""""'`' 1"1 trr"""t.; ADAMS RD PROJECT # sOtT3814 "TEW8/05/8.) 00012461 BUILDING $576.50 MECHANICAL $6.58 PLUMBING $64.00 Building Code Fee $1.50 Energy Studies Surcharge $15.00 =""' $663.50 "^'"°°' "° / � = "= COUNTER ~ PLANS "ATE' / MULTIPLE PERMIT Building Code Fee TOTAL FEE Energy Studies Surcharge TOTAL FEE BUILDING Valuation: Corr 85140 * of Fl *.of Bedrooms 000 PRIMARY STRUCTURE: Desc: DWELLING Group: R-3 g-Ft 1945 opancy Load SECONDARY STRUCTURES: Besc: DWELLINC2F Group: R-3 Sq-Ft 750 Occupancy Load Desc: DWELLINGUB Group: 3 Sq-Ft 750 Occupancy Load Desc; GARAGE Group: M-1 Sq-Ft 800 Occupancy Load # of Rooms 080 Type: VN Rate 32.00 Type: VN Rate 16.00 Type: VN Rate 6.00 Type: VN Rate 8.00 TOTAL FEE Permit Fee MECHANICAL TOTAL FEE VENT : Fan 0 Evap Cooler 0 Hood 0 Duct 0081 Misc 0 Fee FUEL SOURCE: Electric Y Gas N Oil N Coal N Wood N Solar N DISTRIBUTION: Forced Air Y Radiant N Heat Pomp N PLUMBING TOTAL FEE FIXTURES: Bar Sink 0 Drinking Fount 0 Floor Drain 01 Fee C/W Pipe 01 Dish Washer 01 Kitchen Sink 01 Laundry Tray 01 Sewer Eject 0 Water Closet 03 Lavatory 03 Urinal 0 Shower 02 Tub 02 Bidet 0 Other 0 Garbage Disposal 0 Electric Water Heater 01 Roof Drains 0 Fee Sewer ? N Septic/Health * 0 08_O9-~� 877�� �����0u "" ". "" .��'^ ""°'." OFFICE COPY $1.50 $15.00 $576.50 576.50 $6.5 6.50 $64.00 60.00 4.00 DEPARTMENTAL REVIEW I certify that I have examined this application and state that the information contained in it and submitted by me or my agent to compile said application is true and correct. Signatu Date ��� A roved Cond. Approval Hold Environmental Health Application # Q W. 1101 College Room 200 Planning /Zoning N. 721 Jefferson Rc L.? 66' f2 (L --P t- -r,,,, d ^ t 63 • -- 9,- CE.}AsoA Engineers f N. 811 Jefferson ' i —. �1 - _ _ .ice __.r it 7 3 ���; G� • �/z • r aNIGI -I 1iL ' ,L / ........r/ - .. _._ _.114. 6_i /_' ' iillig' / r f y n / e2- a - i; Utilities N. 811 Jefferson Plan Review /Fire Prevention N. 811 Jefferson ° s i. Other (SEPA /Critical Material /etc.) Fast Track /Special Inspection Information Project Representative Phone Address I certify that I have examined this application and state that the information contained in it and submitted by me or my agent to compile said application is true and correct. Signatu Date ���