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6I,,,:.,,I. ^ONSTRUGTIOP' <br />everett PERMIT PERMIT NO. 1 614 <br />CITY HALL 259-8745 <br />EVERETT. WA 98201 ❑ COMBINATION ❑ BUILDING MECHANICAL PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />71P <br />PHONE <br />Boyden Realty, Inc. <br />1429 Broadway <br />Evaratt _ <br />982U1 __ <br />252-1166 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Gary Parkinson <br />527 Medical -Dental Bldg. <br />Everett <br />98201 <br />252-2153 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE. <br />J & D Builders <br />1429 Broadway <br />Everett _ <br />98201 <br />252-1166 223-01 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE. <br />JDBU1223JO <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE F <br />White Coast Plumbing <br />119 Avenue A <br />Snohomish <br />90290 <br />568-6155 <br />CLASS OF WORK <br />5DNEW CIADDITION <br />❑ ALrERAT1ON ❑ REPAIR ❑ DEMOLITION <br />O FENCE <br />❑ SIGN L-I. <br />WOOD STOVFJFIREPLACE INSERT <br />45.000.00 <br />DESCRINE WORK <br />Construct Sinale Family RAniAanra - Rnnir NAR <br />PROPOSED USE OF BUILDING <br />Single Family Residence <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 T) VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER £TATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMAN E OF CONSTRUCTION. <br />SIGNATURE 9FC TRACTOR OR AUTHORIZED A 1 TE <br />X SSG/ <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT 77 eLocK_oF Sunridge Div. III - <br />— <br />JOB ADDRESS <br />112 - 93rd St., S.E., Everett <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 />BATHTUB <br />REFRIGERATION UNITS - N.P. EA. <br />LAVATORY (WASH BASIN) <br />4 <br />BOILERS - H.P. EA. <br />SHOWER <br />2 <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 />_ <br />LAIINDRY TRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />1 <br />CLOTHES DRYERS <br />URINAL <br />2 <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />1 <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEAOERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR. ETC.) <br />1 <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL S <br />20 <br />00 <br />SUB TOTAL B <br />22 <br />50 <br />PERMIT S <br />PERMIT ! <br />TOTAL FEE ! <br />20 <br />00 <br />TOTAL FEE B <br />22 <br />150 <br />SIDE YARD SETBACK <br />PRD <br />STREET SETBACK <br />PRD <br />NEAR YARD SETBACK <br />PRD <br />PLAN CHECK NUMBER <br />06/16147-Basic <br />PLAN <br />FEE <br />-0- <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />R-1 <br />LOT AREA <br />VACANT SITE <br />xYES NO <br />FEES <br />VALUUAnq?ATk��FETYPE <br />OF CONST. <br />V-N <br />OCCUPANCY GROUP <br />R-3 <br />NO. CF DWELLING UNITS <br />1 <br />BUII DING <br />50 <br />SI E F SL <br />NO. OF STORIES <br />MAX.00C. LOAD--524 <br />PLUMBING� <br />500 <br />FI E ZO <br />BASEMENT <br />FIRE SPRINKLERS <br />YES NO <br />MECHANICAL <br />owillREQUIRED <br />50 <br />OTHERwm <br />00 <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />i2 <br />7 (e) <br />.SO <br />2. BUILDING PLANS <br />TOTAL <br />- <br />303 <br />00 <br />3.FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />(}wry( 5(� <br />PERMWHEN ITPROPERLYOVALIDATED IN THIS SPACE) t HTS rXIOUR PERMIT F' <br />K <br />/ll <br />, <br />S. GRADING <br />8. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />S.T.G. <br />APPR. FOR ISSUANCE BY <br />L.N.C. <br />ADDRESS FILE <br />