1986, 12-17 Permit: 00014556 Residence ~. + ‘ .
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S|GNAT~R ' APPLICATION
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OWNER OR - ~ �=. DATE ^^ — — ° _
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JOB ADDRESS PROJECT#
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DATE:
S u183 12/17/86 0001 1' 6
ARNOLD , TED W -NG $ . ;0
:_ E5 WHIf jICAL 6 . 50
=
KANE WA 99206 PLUMBING $5,
HWEST/ HOMES . oiId1ng Code Fee $1 . L
a. '�r�T HOMES Energy Studies Surcharge $15 . 00
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P O jX 141295
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OKAN, WA 9921 .
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SO9- 6-0978 NOR
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�54129l6 |
,`== LOT & BLOCK
011681)00
PLAT NAME:
M{DILOME 4TH ADD
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ZONE FSE "'. "'" ."" .=.
SFR 030 010 020 oo/
61`Q01 RESIDENCE W/CARAGE
USE OF PERMIT:
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JOB ADDRESS: .~..-.. ..~"�... .~�.
:r13 S WHIPPLE ST PIC°
MULTIPLE I' LRMIT
Building Code Fee TOTAL FEE $1 . 50
Energy Studies Surcharge TOTAL FEE $15 . 00
BUILDING TOTAL FEE $450 . 50
Valuation : Corr 57308
' Permit Fee 450 .50
# of Floors 01 # of Bedrooms 000 it of Rooms 000
PRIMARY STRUCTURE :
Desc : DWELLING Group ; Q-3 Type ; VN
g-Ft 1440 Occupancy Load Rate 32 . 00
SECONDARY STRUCTURES ;
Desc : DWE L NCFB Group : R-3 Type : VN
q-Ft 352 Occupancy Load Rate 8 . 00
Desc : DWELLINCUB Group : R-3 Type : VN
Sq-Ft 632 Occupancy Load Rate 6 . 00
Desc : GARAGE Group : M-1 Type : VN
1. Sq-Ft 770 Occupancy Load Rate 6 . 00
MECHANICAL TOTAL FEE $16 . 50
VENT : Fan 0 Evap Cooler 0 Hood 8 DUCT 0001 MiSC 0 Fee 6 . 50
APPL : Dry 0 Range 0 Gas Log 0 Cas W/H 0 Solid Fuel 01 Fee 10 . 00
FUEL SOURCE : Electric Y Cas M Oil N Coal N Wood Y Solar N
DISTRIBUTION : Forced Air Y Radiant Y Heat Pomp N
00
TOTAL FEE $52
PLUMBING .
FIXTURES : Bar Sink 8 Drinking Fount 0 Floor Drain 0 Fee 48 . 00
/W Pipe 01 Dish Washer 01 Kitchen Sink 01
Laundry Tray 0 Sewer Eject 0 Water Closet 02
Lavatory 04 Urinal 0 Shower 01
Tub 01 Bidet 0 Other 8
GarbageDisposal 01 _
Electric Water Heater 01 Roof Drains' � .8l _ O � � O � '"e*�� � � �u00
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Sewer ? N Septic/Health # 0 � ^ ^ " " " v ^ ~ / ' � /
. OFFICE COPY
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DEPARTMENTAL REVIEW
Cond.
Approved Approval Hold
ef, Environmental Health Permit Number
W. 1101 College
Room 200 e
Planning/Zoning
❑ N.721 Jefferson _
Engineers Permit Number/ /a.
El N.N.811 Jefferson F6 F/r,4 3
Utilities
0/N.811 Jefferson /7
Plan Review/Fire Prevention
❑ N.811 Jefferson
ci 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 is true,correct,legal,a.nd"bindmg.
Owner's Signature / Date __( Z ( 7— ��
tbPJ Lht 7- idn?ets [lee, /7 $61
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