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the E'Yergreen <br />CITY OF <br />everett <br />"061ONSTRUCTIOP- <br />CITY HALL 2548745 P E R M I T <br />EVERETT, WA OB201 ® COMBINATION <br />r-. <br />❑ BUILDING ❑ MECHANICAL <br />PERMIT NO. 16173 <br />❑ PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Boyden Realty, Inc. <br />ARCHITECT <br />1429 Broadway <br />Everett <br />98201 <br />252-1166 <br />OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Gary Parkinson <br />527 Medical -Dental Bldg. <br />Everett <br />98201 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />LIT, <br />_ <br />ZIP <br />_252-2153 <br />-""ONE LICENSE <br />J & D Builders <br />1429 Broadway <br />Everett <br />98201 <br />;.52-1166 223-01 <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE F <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />JDBU1223JO <br />Rite ODeat Plumbing <br />119 Avenue A <br />Snohomish <br />98290 <br />PHONE LICENSE E <br />568-6155 <br />CLASS OF WORK <br />I&NEW ❑ ADDITION <br />0 ALTERATION ❑ REPAIR <br />❑ DEMOLITION ❑ FENCE <br />❑ SIGN ❑ <br />WOOD STOCF FIREPLACE INSERT <br />$46,000.00 <br />DESCRIBE WORK _. <br />New Single Family Residence - Ba i "8" <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 />LEGAL DESCRIPTION Of PROPERTY (SHOW BELOW OR ATTACH FOUR COPIE81 <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />LOT 63 BLOCK —OF Sunridge Div. III <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANT;NG 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 CONSTRUCTION OR 1HE <br />JOB ADDRESS -- <br />PERFORMAN OF CONSTRUCTION. <br />201 - 93rd St., S.E., Everett <br />7 <br />SIGNATURE O TRACTOR OR ALTrypryZED AOFNT , GATE <br />x <br />L}/ G <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSETITOILE7) <br />AIR COND. UNITS - H.P. EA. <br />1 <br />BATHTUB <br />2 <br />REFRIGERATION UNITS - H.P. EA. <br />LAVATORY IWASH BASIN) - <br />2 <br />4 <br />00 <br />BOILERS - H.P. EA, <br />1 <br />SHOWER <br />2 <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />1 <br />KITCHEN SINK A DISP. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />1 <br />DISHWASHEP <br />WALL HEATERS - B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS - B.T.U. M <br />1 <br />CLOTHES WASHER <br />2 <br />bOEVAPORATIVE. <br />COOLERS <br />1 <br />WATER HEATER <br />1 <br />CLOTHES DRYFRS <br />URINAL <br />2 <br />VENTILATION FAN <br />0 <br />DRINKING FOUNTAIN <br />1 <br />RANGE HOOD <br />In <br />_- <br />FLOOR GRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />STOVE - WOOD <br />ROOF DRAINS - RAINLEADERB <br />METAL FIREPLACE A CHIMNEY <br />SINK ISERVICE - BAR, ETC.) <br />1 <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL I <br />20 <br />0 <br />BUD TOTAI t <br />2i <br />50 <br />PERMIT I <br />PERMIT I <br />TOTAL FEE <br />I 20 O <br />TOTAL <br />FEE f 22 in <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK FEE <br />PAD <br />PRO <br />PRO <br />86/16173 - Basic <br />FEE -D- RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />R-1 <br />XYES NO <br />TYPE OF COMET <br />OCCUPANCY GROUP <br />NO, OF DWELLING UNITS <br />wng Code SUrch <br />r9 <br />1 <br />50 <br />V-N <br />R-3 <br />1 <br />BUILDING <br />146 000.00 <br />265 <br />0 <br />SIZE OF BLDG. <br />NO. OF -STORIES <br />MA%. OCC. LOAD <br />1549 SF <br />2 <br />6 <br />PLUMBING <br />FIRE ZONE <br />9ASEMENi <br />FIRE SPRINKLERS <br />20 <br />REQUIRED <br />MECHANICAL <br />22 <br />YES NO <br />50 <br />APPROVALS <br />BY <br />DATE <br />OTHER Driveway <br />31 <br />OoD6� <br />0bu <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />U.B.C. <br />2. BUILDING PLANE <br />J. FIRE HYDRANT <br />qa <br />TOTAL Boo ,iSI.00 <br />A. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN �SPACEI����7UR PEPMIT (17 <br />pt �� <br />Ip,p IE�I $2Z,SO ^� <br />G G �� t rl <br />.00 <br />M" $30 00 <br />S.GRADING <br />B. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />M.M. <br />S.T.G. <br />L. G. C. <br />00111 $330.00 <br />XONT INUEt <br />ADDRESS FILE 9 <br />