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en <br />the EcCII, <br />^,ONSTRUCTIOP' <br />OF <br />everett <br />PERMIT <br />PERMIT NO. <br />15116 <br />CITY HALL 259 87A5 <br />EVERETT. WA 98201 ❑ COMBINATION <br />® BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />OWNER <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE <br />Gene Closer <br />4212 Rucker Everett 98203 <br />ARCHITECT OR DESIGNER <br />MAIL AGGRESS CITY <br />ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE A <br />Star Home improvement <br />5314 - 2nd St. Everett <br />353-9278 STAR 177 RB <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE A <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY <br />ZIP <br />PHONE LICENSE A <br />CLASS OF W VHn <br />W NEW ❑ADDITION ❑ ALTERATION O REPAIR ❑DEMOLITION ❑FENCE O SIGN ❑ WOOD STO\'EIFIREPLACE INSERT <br />38,000.00 <br />DESCRIBE WORK <br />Lnsrall block iounuatiun unuuL <br />u^ 6. Lu <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />Sin le FamilyResidence <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LEGAL DESCRI PTION OF PROPERTY )SHOW BELOW OR ATTACH FOUR COPIES) <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />LOT 7 SLOCK23 OF South Park <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 />I <br />LOCAL LAW REGU TING CONSTR CTION OR THE <br />E <br />SPEIIG), E C T ON. <br />SIG 1, TU E 0 NTRA OR R U'TON AGE DAT <br />JOB ADDRESS <br />4212 Rucker <br />X <br />PLUMBING <br />MECHANI AL <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 (HASH BASIN) <br />BOILERS - H.P. EA. <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK 8 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 8 CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />f <br />SUB TOTAL_ $ <br />PERMIT <br />F <br />PERMIT <br />TOTAL FEE <br />f <br />TOTAL FEE. $ <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN <br />CHECK FEE <br />N/A <br />N/A <br />N/A <br />85/15116 <br />FEE 44.53 <br />RECEIPT NO. <br />770g4 <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />B-2 <br />N/A <br />YES xNO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING <br />18,000.00 <br />68 <br />50 <br />V—N <br />R-3 <br />1 <br />SIZE OF FILDG. <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />N/A <br />1 + basem71RIEOUIRED <br />N/A <br />PLUMBING <br />FIRE ZONE <br />BASEMENT <br />E SPRINKLERS <br />MECHANICAL <br />ES ]NO <br />OTHER <br />APPROVALS <br />BY <br />DATE <br />U.B.C. <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SEC. 303 (a) <br />2. BUILDING PLANS <br />TOTAL <br />68 <br />50 <br />3. FIRE HYDRANT <br />_ <br />A. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Lr <br />5. GRADING <br />r <br />Lf' <br />r' <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />_ <br />6. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />N.M. <br />JEF <br />L.C. <br />ADDRESS FILE <br />