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the EverRmn <br /> ��T�o. '� ��rt��1'�lI�CT�C�I� � <br /> eve�r���� Ky ��;���Y aeRMir No. 16169 <br /> q7V HALL 259B715 <br /> EVERET7,tkA 982pt � COMBINATION C BUILDINi3 ❑ MECHANICAL ❑ PLUMBING <br /> OWNER MRIL ADDRE55 dTY <br /> Z�P FHONE <br /> Boyden Realty, Inc. 1929 Broadway �erett 98201 252 1166 <br /> �RCHRECT ON DESIGNER MRIL pD�PE55 dTY Z�p <br /> P110NE <br /> Gary Parkinson 527 Medical-A:ntal Bldg. �.erett 98201 252-2153 <br /> GENEN�L CONTNACTOR MRIL ADDRE55 CITY <br /> Z�P PNONE LICENSE I <br /> J & D Builders 1929 Broadwav Everett 96201 252-1166 223-01 <br /> MECH�NICAL CONTRRCTOR MAIL AOCRESS CItY ZIP PHONE LICENSE• <br /> PWMBING CONTR�GTOR MqIL AD�RE55 CITY J�UZZZjJO <br /> Z�P PMONE LICENSE� <br /> White Ouast Plumbin 11j Avenue A Snohomish 98290 568-6155 <br /> CLnSSOF WORK <br /> �NEW ❑ADDITION ❑ qLTERATION O REPAIR ❑ DEMOL�TION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSF.R7 <br /> VALUATION OF 1/ORN � <br /> s96,000.00 <br /> OESCRIBE WORN - <br /> New Single Family Residence - Basic "B" <br /> PROP(�SEO USE OF BUIL�ING <br /> Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGALDESCRIPTIONOFPqOPERiY�SMOWBELO\YORATTACMFOURCOPIES) tiPPLICATION AND KNOW THE SA�AE TO BE TRUE AND <br /> CORFiECT. ALL PROVISIONS OF LAWS AND ORDINANCFS <br /> ior 72 BLOCK__OF Sunrid e Div. iii GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WI1�H <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 CONSTfiUCTION OR THE <br /> �oenooness PERFORMAN OF CONSTRUCTION. <br /> SIGNATl1RE TRACTOR OR AUiMORIZE�AGENi pAT <br /> _ 9216 - lst Dr. , S.E. , Everett X �' ��,�,� � �o <br /> PLUMBING r• MECHANICAL ~ <br /> N�— TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET) 4 OO AIR COND. UNIiS—H.P. EA. <br /> ]. BATHTUB — <br /> Z OO REFRIGERATION UNITS— M.P.EA. <br /> 2 LAVATORY(WASH BASIN) �] �� BOILERS— HP. EA. <br /> 1 SMOWER Z 00 GAS FIRED A.i,.UNITS—TONNAGE EA. <br /> 1 KITCHEN SINK 6 DISP. 2 FORCED AIR SYGTEAS— B.T.U. M EA. <br /> 1 DISMWASHER -- <br /> Z OO �'�'AL�HEFTERS— B.T.U. M <br /> LAUNDRY TRAI' UNIT HEATERS— B.T.U. M <br /> 1 CLOTHES WASHER Z � EVAPORqTIVE COOLERS <br /> 1 WATER HEATER 2 QD CLUTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DFINKING FOUNTAIN RANGE MOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WpOD <br /> ROOF ORAINS— RAINLEADERS METAL FIREPLACE 8 CMIMNEY <br /> SINN(SERVICE— BAR,ETC.) <br /> FIREPLACEINSERT � <br /> HEAT PUMP <br /> SUB TOiAL f 20 00 SUB TOTAL S ZZ 5 <br /> PEpM17 S PERMIT S <br /> TOTAL FEE S 20 OO TOTAL FEE _ <br /> SIOE VARD SETBACK STREET SETBACK � <br /> REAR YAqD SETOACK PLAN CMECK NUMBER PLAN CHECK FEE <br /> PFD PRD PRD 86/16169 — Basic FEE _�_ RECEIPT NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> R-1 XYES . NO FEES �p �—�� <br /> TVPE OF CONST. OCCUFFNCY GROUP NO.OF DWELLING UNITS BU11C�1RCJ COCIO Surch 16104 1 SO <br /> V-N iLCOda Snrrhwr <br /> R-3 1 BUILOING <br /> SIZE OF BLDG. NO.OF STOHIES MAX.OCC.LOAD B4 O.O �� Z6S OO <br /> 1$49 SF Z 6 PLUMBING �� �,2 �� Z� �0 <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECMANICAL PL�] .� <br /> FEOUIRED <br /> �.:YES ::NO ZZ SO <br /> APPROVALS BV DATE �THER Driveway Pe .�� �� 20 �p <br /> 1.ENVIRONMENTAL CMECK LIST PENALTY Z <br /> 2.BUILDING PLANS a <br /> 3.FIREHYORANT TOTAL �.�.r� �� OO <br /> d.FIRE PROTECTION SYSTEM PEPMIT VAIIDqTION �� ��m <br /> S.GRADING WHEN PROPERLY VALIDAT@D pN�ffiACE i�l �S.YqUR PFRMIT � <br /> 6.DflAINAGE 1 W <br /> c►�� i�s�.00 , <br /> 7.ENVIRONMENTALIMPACTSTATEMENT <br /> 8.MEAITH DISTRICT � , <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BV � : <br /> Df.M. S.T.G. L.N.C. <br /> ADDRESS FILE <br />