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the t'Y"' <br />C17OFOF 0 �ONSTRUCT1O% <br />ITY <br />everett PERMIT PERMIT NO. 15501 <br />CITY HALL 259 8745 <br />EVERETT. WA 98201 ® COMBINATION BUILDING ❑ MECHANICAL ® PLUMBING <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Barbara Karr 1901 Rainier Everett 98201 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE Y <br />DeLeon Custom Homes 5913 Glenwood #B Everett 98203 347-3178 <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE If <br />DELENCH156JH <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE a <br />❑ NEW ❑ ADDITION ❑ ALTERATION 18 MEPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />VALUATION OF WORK <br />$ 16,500.00 <br />Repair existing residence Chip <br />PAIDPOSED USE OF BUILDING <br />Single Family Residence <br />LOT 1-2 BLocR386 —IF Everett Div. P <br />JOB ADDRESS <br />1901 Rainier <br />Q <br />V <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 />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE <br />ri <br />9/30/85 <br />PLUMBING <br />MECHANICAL <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 />1 <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />1 <br />LAVATORY (WASH BASIN) <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />_ <br />KITCHENSINKB 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 S <br />4 <br />SUB TOTAL f <br />_ <br />PERMIT S <br />PERMIT 5 <br />_ <br />TOTAL FEE S <br />4 <br />0 <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />FEE <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />YES NO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />5 16 SOO. <br />122 <br />SO <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />4 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />YES NO <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 />126 <br />50 <br />3. FIRE HYDRANT — <br />_ <br />4. FIRE PROTECTION SYS M <br />J 5.GRADING - <br />PERMITVALIDATION <br />WHEN PROPERLY VALIDATED IIN TH`S II P(.CE) THIJI$ Yff P�TIT <br />j I I <br />, <br />YOUR f I C E I F' r <br />'>-i_I!'.N1: YOU <br />6. DRAINAGE r� <br />T ENVIRONMTNTAL IMFA& STATEMENT <br />B. HEALTF+DISThIC <br />A PL CATION-r11CCTBY <br />PLANS CHEGKEO BV <br />APPR. FOR ISSUANCE BV <br />:a <br />ADDRESS FILE <br />2 9 SEP 8 5 <br />