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Ow Evergreen <br />CITY OF <br />everett <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 <br />60NSTRUCT10% <br />PERMIT PERMIT NO. 16528 <br />❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Beter & Catherine Van Tuvl 1726 Rainier Ave Everett, WA 98201 258-6948 <br />ARCHITECT OR 0 SIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 0 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE III <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />❑ NEW ❑ ADDITION 711 ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />f EStimated $400. <br />DESCRIBE WORK <br />Bantam 2 nillar r. cost with masonry block wall foundation. Add pillar and host <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 CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNAT OF CONJ'iACTOR OR AUTHORIZED AGEN DATE <br />X / 2l <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />20 6 S � of 21 <br />LOT_BLOCK, 53 OF DiV''sion U <br />JOB ADDRESS <br />1726 Rainier Ave <br />PLUMBING <br />M CHANIC <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS — H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA, <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />DISHWASHER <br />WALL HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C.F.M. <br />VACUUM BREAKERS <br />STOVE — WOOD <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE — BAR. ETC) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />41 <br />SUB TOTAL f <br />PERMIT <br />f <br />PERMIT $ <br />TOTAL FEE <br />f <br />TOTAL FEE S <br />SIDE YARD SETBACK <br />N.A. <br />STREET SETBACK <br />N.A. <br />REAR YARD SETBACK <br />N.A. <br />PLAN CHECK NUMBER <br />86/16528 <br />PLAN <br />FEE 6.50 <br />CHECK FEE <br />RECEIPT NO. <br />79034 <br />USE ZONE <br />N.A. <br />LOT AREA <br />N.A. <br />VACANT SITE <br />YES XNO <br />FEES <br />VALUATION <br />FEE <br />Building Code SurchBrge <br />1 <br />50 <br />TYPE OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />N0. OF DWELLING UNITS <br />-- <br />BUILDING <br />f 400.00 <br />10 <br />00 <br />SIZE OF BLDG. <br />N.A. <br />NO. OF STORIES <br />2 <br />MAX. OCC. LOAD <br />--- <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES ]PJO <br />MECHANICAL <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />50 <br />3. FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION O5I <br />WHEN PROPERLY VALIDATED (IN THIS SPAjtE) THIS IS YOUR PERMIT OC <br />NO1= 01 <br />B 8AQ1 $1.50 IJI <br />81DG f10.00 C.Q <br />qfq( $11.50 `J <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. HEALTH DISTPICT <br />APPLICATION ACC. BY <br />M. M. <br />PLANS CHECKED 6Y <br />JEF <br />APPR. FOR ISSUANCE BY <br />L.C. <br />Eji <br />ADDRESS FILE <br />