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the f'vergirrn <br /> ��T�°F 'i �ONSTRUCT141� � <br /> e�erett P E R M I'� PERMIT NO. 1615 Z <br /> CITV MALL 254B7�5 <br /> EVERETT,WA 98201 [� COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> �WNER MFIL ADDRESS CITY <br /> Boyden REalty, Inc. 1429 Broad�ray Everett 98201 252N1166 <br /> •F�MITECT OR DESIGNEF MqIL ADDRESS QTY ZIP PHONE <br /> Gary Parkinson 527 Medical Dental Bldg Everett 98201 252-2153 <br /> GENERRLCONTRRLfON MAIL�pDRESS CITY ZiP PMONE LICENSE• <br /> J & D Builder.s 1429 Broadway Everett 98201 252-1166 JDBUI223J0 <br /> MECH�NICAL CONTPACTOR IARII FOUPE55 CITY Zlp PHONE UCENSE� <br /> PLUMBING CONTRFCTOP MAIL qODRE55 CITY ZIP PMONE LICENSE I <br /> White Coast Ylumbing 119 Avenue A Snohomish 98290 568-6155 <br /> cuss oF wonK - <br /> �()NEW ❑ AODITION ❑ ALTERATION ❑REPAIR O OEA!OLITION O FENCE ❑ SIGN O WO00 STOVE/FIREPLACE INSERT <br /> VALUATION OF WOPK <br /> S 4$�000.00 <br /> DESCRIBE WORK '" <br /> Construct Single Family Residence, Basic Plan 'A' <br /> PROPOSED USE OF BUILDING <br /> Single Family Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �EGRIDESCPIPT10NOfPROPENiY�5MOW8ELOWORATiqCHFOURCOPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROV�SIONS OF LAWS AND ORDINANCES <br /> �or 73 BLOLN_OF Sunrid e Div. III GOVERNING THIS Tl'PE 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 PROVIS�ONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMAN OF CONSTRUCTION. <br /> JOB.�DOPESS SIGNAiUPE OF � Rp�}OR OR AUTH EO AGEN OAT <br /> 9z - � sE x �" ,-- � ,�' G A s� <br /> PLUMBING MECHANICAL - <br /> N0. TYPE OF FIXTURE OR ITEM FEE IiO. TYPE OF E�UIPMENT FEE <br /> 2 WATERCLOSET�TOILET) 4 OO AIR COND.UNIiS— M.P.EA. <br /> ], 6ATHTUB Z OO HEFRIGERATION UNITS— H.P. FA. <br /> 2 LAVATORV(WASH BASIN) Q OO BOILERS— H.P.EA. <br /> 1 SHOWER Z OO GAS FIRED A.C.UNITS—TONNAGE EA. <br /> 1 KITCHEN SINK 8 DISP. 2 OO FORCED AIR SYSTEMS— B.T.U. f.1 EA. <br /> 1 DISHWASHER 2 00 WALL HEATERS— B.T.U. M <br /> LAUNDRVTqAY UNIT HEATERS— B.T.U. M <br /> 1 CLOTHES WASHER 2 OO EVAPORATIVE COOLERS <br /> 1 WATER HEATER 2 OO 1 CLOTMES DRYERS 4 SO <br /> URINAL 2 yENTILATION FAN 6 OO <br /> DRINKING FOUNTAIN RAtJGE HO00 <br /> FLOOR DRAIN AIR HANDLIryG UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF�RAINS — RAINLEADERS 1 METAI FIREPLACE d CNiMNEY � SO <br /> SINK(SERVICE — BAR, ETC.) FIREPLACE INSERL <br /> HEAT PUMP <br /> SUB TOTAL i ZO OO SUB TOTAL f ZZ SO <br /> PERMIT S — — PERMIT f — <br /> TOTAL FEE S ?O OO TOTRL FEE f ZZ SO <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PIAN CHECK NUMBER PLAN CHECK FEE <br /> P� P� PRD 86/16152 Basic FEE none RECEIPT NO. <br /> USERZQNE l07 AREA VACANT SITE <br /> 1 :�VES . 'NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP N0.OF DWELLING UNIiS BUISCIIR -COCIE SUL arge 1 O <br /> V-N R-3 1 cle_�rcha e 15 0 <br /> BUILDING y95,000 260 50 <br /> SIZMOE BLDCn.��� ryp.OF i q1ES MA%.OCC. IOAD <br /> � l 4 PLUMBING 2O OO <br /> PIREZONE BASEMENT FIRESPRINKLERS MECHANICAL <br /> PEOUIRED .��� 3� ��i� 5� <br /> YES . NO <br /> APPROVALS BY UATE �THER DL1V2WdY � � ZO O <br /> i.ENVIflONMENTALCMECK UST PENALTY <br /> 2.BUILDINGPL.�NS �la) I..� <br /> 7.FIREHYDRANT TOTAL E SRCH f �,SO <br /> d.FIRE PROTECTION SYSTEM PERMIT VALIDATION pp(; �n�� (�(� <br /> 5.GRADING WHEN PROPERLY VALIDATED QN'7M1�•SPACE)719MJ'19'TOJR PERMIT (v <br /> 6.DRAINAGE �� _�.� �{� <br /> 7.ENVIRONMENTALIMPACTSTATEMENT �� �•� rI <br /> B.HEALTH DISTRICT �� ��� L� <br /> APPUCATION ACC.BY PLANS CHECKED BY APpq.FOR ISSUANCE BY � f�'� ��-' <br /> BtDIII t330.00 <br /> M.M. STG LC �� ��•� <br /> ADDRESS FILE <br />