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the Evergreen <br />CITY OF <br />everett <br />CITY HALL 25"745 <br />EVERETT. WA 98201 <br />�o WONSTRUCTIO16 <br />PERMIT PERMIT NO. 16306 <br />❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />Z.P PHONE <br />Frank Jacobs <br />3507 Rockefeller <br />Everett 98201 <br />252-7346 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE I <br />Everett Builders, Inc. <br />5606 Evergreen Way <br />Everett 98203 353-7161 <br />EVEREB*3-llL3 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY ZIP <br />PHONE LICENSE A <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE t <br />❑ NEW ❑ ADDITION S] ALTERATION ❑ REPAIR ❑ UEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />52,857.00 <br />DESCRIBE WORK <br />4' x 10' front porch and level front of house <br />PROPOSED USE OF BUILDING <br />single family residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION A14D 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 OP 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 OW REGULATING CONSTRUCTION OR THE <br />PER R ANCF 0 CONSTRUCTION. <br />SIG NATU. F CONTJ;aC OR AUTHOR( D G NT D TE <br />X <br />LEGAL DESCRIPTION OF PROPERTY ISHOV, BELOW OR ATTACH FOUR COPIES( <br />4 & 5 865 Plat of Everett Div M <br />LOT —BLOCK —OF_ <br />JOB ADDRESS <br />3507 Rockefeller <br />PLUMBING <br />NC. _TYPE OF FIXTURE OR ITEM FEE <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT 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 S <br />SUB TOTAL S <br />PERMIT $ <br />PBRMIT S <br />TOTAL FEE $ <br />TOTAL FEE $ <br />SIDE YARD SETBACK <br />20' <br />STREET SETBACK <br />201 <br />REAR YARD SETBACK <br />51 <br />PLAN CHECK NUMBER <br />86/16306 <br />PLAN <br />FEE 25.03 <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />R-3 <br />LOT AREA <br />6000 SF <br />VACANT SITE <br />.-:YES XNO <br />FEES <br />- <br />VALUATION <br />FEE <br />TYPE OF CONST. <br />V-n <br />OCCUPANCY GROUP <br />R-3 <br />NO. OF DWELLING UNITS <br />1 <br />BUILDING <br />$2857.00 <br />38 <br />50 <br />SIZE OF BLDG, <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />FIROUE SPRINKLERS <br />REIRED <br />I 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 (e) <br />2. BUILDING PLANS <br />TOTAL <br />38 <br />50 <br />3. F-RE HYURAN'. <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHET°ROPERLY VALIDATED (IN THIS SPACE) THISISYOUR PERMIT CD <br />11I 2 2 Y 0 3 S. ) 0 -- <br />M <br />\ ._ 1j i 1 RECEIPT <br />i _-! %,,!.IYOU <br />S. GRADING <br />6. DRAINAGE -- <br />— <br />7.ENVIRONMENTAL IMPACT STATEMENT <br />6. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />M. M. <br />PLANS CHECKED BY <br />SIG <br />APPR. FOR ISSUANCE BY <br />L.C. <br />ADDRESS FILE 2 9 VAR 86 <br />