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IRA EW918rK kPPLICATION FOk'� <br />CITY or CONSTRUCTION U <br />everett PERMIT <br />1') HI: COMPLETED IN BLACK INK— PLEASE PRINT <br />BUILDING DEPT. <br />259.8745 ❑ <br />COMBINATION ® <br />BUILDING ❑ MECHANICAL <br />❑ PLUMBING ❑ SIGN <br />OWNER <br />Boyden Realty, Inc. <br />MAILAOOEBs <br />1429 Broadway <br />CITY <br />Everett <br />ZIP <br />98201 <br />PHONE <br />252-1166 <br />ARCIUTFCI ORDESICNER <br />Gary Parkinson <br />MAIL AOORFRS CITY <br />527 Medical Dental Bldg. Everett <br />ZIP <br />98201 <br />P!MNE <br />252-2153 <br />GENERALCONTRACTOR <br />J bDBuilders <br />MAIL ADDRESS <br />1429 Broadway <br />Everett <br />98201 <br />P1 ON, LICENSE <br />252-1166 223-E 01 <br />MECHANICAL CONTRACTOR <br />WIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE E <br />JDBUI22330 <br />PLUMBING CONTRACTOR <br />White Coast Plumbing <br />MAIL AOORESS <br />119 Avenue A <br />CITY <br />Snohomish <br />ZIP <br />98290 <br />PNONE LICENSE E <br />568-6155 <br />NEW V . ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />vALUAOON Or WORN [COST 01 MATERIALS PLUS LABOR <br />UESCNRE WOBA <br />e..... CI«nl« Fnmily Rnalrlenre - Plan <br />URti a A.PI DING V <br />bFR <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE ANDCORRECT. ALL <br />PROVISIONSOF LAWS AND ORDINANCES GOVERNING THISTYPE <br />OF NORK WILL BE COMPLETEDWITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION, <br />SIGNATURE OF C01(11 f1��,l7OR OR 11UIIIOR O AOFNf(// A�AEE <br />X / <br />LEGAL DESCRIPTION Or PBOPEPTY[SNOWN BELOW OR ATIACN FOUR COPIES! <br />80 Sunridge Div. III <br />124 - 93rd St., S.E., Everett <br />PROJECT ADDRESS <br />APPLICA tS CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />WATER CLOSET [TOILER <br />Ain COND. UNITS-H.P. EA <br />_ <br />BATHTUB <br />___ <br />__ <br />nEFRIGERATION UNITS-H.P. EA <br />LAVATORY jYVASH BASIPQ <br />BOILERS-H.P. EA <br />SHOWER <br />OAS FIRED AG UNITS -TONNAGE EA <br />FORCED AIR SYSTEMS-B.T.U. MEAL <br />KITCHEN SINKS DISP. <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />LAUNORYTRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHES WASHER <br />I 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 <br />ROOF DRAINS-RAINLEAgEnS <br />METAL FIREPLACE S CHIMNEY <br />_ <br />SINK SERVICE -BAP, EIC.) <br />WOODSTO FIREPLACE INSERT <br />SUB TOTAL <br />SUBTOTAL • <br />_ <br />PERMIT • <br />PERMIT • <br />TOTALFEE • <br />TOTAL FEE • <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />BEAR sETSACK <br />SIDE BE (SACK <br />LUI AREA <br />VACANT SITE <br />OYES ONO <br />OCCUPANCY GROUP <br />NO Of DWELLINO UNITS <br />NO OF STORIES <br />MAX OCC LOAD <br />7ED O YES ONO <br />PIAN'ICNECREPBI <br />APPB FOR ISSUANCE BY <br />1/G <br />dip 1(A/.90 <br />Fees <br />FEE -0- <br />VALUATION <br />AECEIPI NO <br />F <br />BUILDING <br />• <br />PLUMBING <br />MECIIANICAL <br />OTIIER <br />PENALTY <br />TOTAL <br />