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IA. EYE.PTfER ~CONSTR � TIONk [YfF[n <br />CITY Of <br />everett PERMIT <br />TO BE COMPLETED IN BLACK INK - PLEASE PRINT <br />BUILDING DEPT. <br />259.8745 ❑ <br />COMBINATION ® <br />BUILDING ❑ MECHANICAL <br />❑ PLUMBING ❑ SIGN <br />UNNIN <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Boyden Realty, Inc. <br />1429 Broadway <br />Everett <br />98201 <br />252-1166 <br />ARDIIITrCT OO DE91OI1T O <br />MAIL APII0ER9 <br />CITY <br />ZIP <br />PHONE <br />Cnry Parkinson <br />527 Medical Dental Bldg. Everett <br />98201 <br />252-2153 <br />GENERAL CONNIACTOR <br />MAIL Amn EBB <br />CITY <br />ZIP <br />PHONE LICENSE E <br />J 6 D Builders <br />1429 Broadway <br />Everett <br />98201 <br />252-1166 223-01 <br />MECHANICAL CONTRACT' B <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE E <br />JDDUI223JO <br />PLUMRINO CONNIACIOP <br />MAILARDITEBB <br />CITY <br />ZIP <br />PTIONE LICENSEE <br />White Coast Plumbing <br />119 Avenue A <br />Snohomish <br />98290 <br />568-6155 <br />I LASSOF WORK <br />C3 NEW ❑ ADDITION ❑ ALTERATION <br />❑ REPAIR <br />❑ DEMOLITION ❑ WOODSTOVE/FRPLANSET T ❑ BUILDING RELOCATION <br />VALUATION OE WORK [COST Of MATERIALS PLUS LASOIS <br />INSCIRSE WORK <br />New Single Family Residence - Plan <br />SFR V I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUEANDCORRECT.ALL <br />LEGAL DESCRIPTION OF PROPERTYIBHOWN BELOW OR ATTACH rCUn GOPIEa PROVISIONSOF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />78 Sunridge Div. III OFWORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />_ LOT__RLOCTOF IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OP LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />BIONAEURE OI CONTRA OR OR AUTI/I �RI2E AGENT�ATf. �/J�f <br />116 - 93rd St., S.C., Everett x �� �i'1'Yt-� <br />PROJECT ADDRESS <br />APPIICAMT CIIY BUSINEP9 LICENSE NO V <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO <br />TYPE OF EOUIPMENT <br />_ <br />FEE <br />WATER CLOSET TOILE <br />AIR COND. UNITS-H P. EA <br />BATHTUB <br />REFRIGERATION UNITS-H.P. EA <br />LAVATORY WASH BAST <br />BOILERS-H.P. EA <br />_ <br />SHOWER <br />OAS nnED AC. 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 />_ <br />LAUNDRY TRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />HEATER <br />CLOTHES DRYERS <br />_WATER <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 <br />DRAINS-RAINLEADERS <br />METAL FIREPLACES CHIMNEY <br />_ROOF <br />SINK SERWCE-BAB EIC. <br />WOODSTOVE/FInEPLACE INSERT <br />_ <br />_ <br />BUD TOTAL <br />_ <br />SUE TOTAL • <br />PERMIT • <br />TOTAL FEE • <br />_ <br />PERMIT • <br />_ <br />TOTALFEE • <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />ERONI SE TRACK <br />BEAN SETBACK <br />SIDE SETBACK <br />PLANCNEC.KNUMOFN <br />8o f/4 / y <br />/L PLANCNECKfEE <br />TIE �EVyi RECEIPT NO <br />USE ZONE <br />LOT AOFA <br />VACANT RITE <br />I1YE8 aN0 <br />— <br />f[n <br />VALUATION <br />f[! <br />_ <br />nPE or CORSI <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />BIiE OE RLDO <br />NO UE flIONEB <br />MAX OCC LOAD <br />PLUMBING <br />FIRE SPnINKLERS nEUU1RED U YES O NO <br />MECHANICAL <br />OTHER <br />PENALTY <br />APPLICANONALC BY <br />PLAN9CIIELKEDBY <br />'v L% <br />APPR FOR ISSUANCE BY <br />TOTAL <br />