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APPLICATION F-Oh. <br />""° CITY Of CONSTRUCTION <br />CITY O! <br />everett PERMIT <br />TO BE COMPLETED IN BLACK INK - PLEASE PRINT <br />BUILDING DEPT. <br />259-8745 ❑ COMBINATION ® BUILDING ❑ MECHANICAL <br />❑ PLUMBING ❑ SIGN <br />OWNER -- <br />Boyd�n Realty, Inc. <br />MAIL AROGrso <br />1429 Broadway <br />CITY <br />Everett <br />ZIP <br />98201 <br />PHONE <br />252-1166 <br />_ --- <br />ABCNI a CIO" DESIGNER <br />Cary Parkinson <br />MAIL AIIUOEBS <br />527 Medical Dental <br />CITY <br />Bldg. Everett <br />on., <br />98201 <br />PHONE <br />252-2153 <br />GE HE nAL CONTRACTOR <br />J 6 D Builders <br />MAIL ADOnr55 <br />1429 Broadway <br />CITY <br />Everett <br />ZIP <br />98201 <br />Pit THE <br />252-1166 <br />LICENSE <br />223-01 <br />MECHANII;., CONTRACTOR <br />MAIL ADORERS <br />CITY <br />ZIP <br />PHONE <br />JDAU1223JO <br />LICENSE E <br />PLUMRI.IO CONTRACTOR <br />White Coast Plumbing <br />MAIL ADDRESS <br />119 Avenue A <br />CITY <br />Snohomish <br />DP -- <br />98290 <br />PHONE <br />568-6155 <br />LICENSE E <br />CURB OF WEAK <br />9 NEW ❑ ADDITION ❑ ALTERATION ❑ nEPAIn ❑ DEMOLITION ❑ WOODSTOVE/FnPL.INSERT ❑ BUILDING RELOCATION <br />YAUTAHO9 W V'(AM ICOSI OF MAIFFHALR PLUS LABOE <br />OE SCRIBE WORM <br />New Single Family Residence - Plan <br />USE Or BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO Pt TRUE ANDCORRECT.ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OF A PEnmII DOES NOT PRESUME TO <br />DIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br />ANY OTHER STATE On LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. / <br />SIGNATURE Of QONIR ORORAUTH RIZEDAGENT DATE,) s S'y <br />x iT �� Y1� <br />LEGAL DERCniPGON Or PnOPERIVISIIOWN BELOW OR ATTACH FOIGCOPIEN <br />61 Sunridge Div. III <br />Lot_BLMM or <br />213 - 93rd St. S.E. Everett <br />PROJECT AGGRESS <br />APPLICANTS CITY BUSINESS LICENSE <br />PLUMBING <br />MECHANICAL <br />TYPE OF FOUIPMENT FEE <br />NO. <br />_ <br />TYPE OF FIXTURE <br />FFE <br />NO. <br />WATER CLOSET (TOILET) <br />AIR COND. UNITE-H.P. EA <br />, <br />BATHTUB <br />REFRIGERATION UNITS-H.P. EA. <br />_ <br />LAVATOnY(WAS" BASINI <br />BOILER9_H,P. EA <br />_ <br />SHOWER <br />OAS PIPED A.C. UNIIB-TONNAGE EA <br />_ <br />_ <br />KITCHEN SINK • DISP. <br />FORCED AIR SYSTEMS-111.U. M EA <br />DISHWASHER <br />WALL HEATERS-B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS-B.T.U. M <br />CLOTHES WASHER <br />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-RAINLEADERS <br />METAL FIREPLACES CHIMNEY <br />BINK(SEBVICE-BAn, ETC. <br />WOODSTOVE/FInEPLACE INSERT <br />_ <br />BUB TOTAL <br />BUE TOTAL • <br />PERMIT • <br />PERMIT • <br />TOTALFEE • <br />_ <br />TOTALFEE • <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />FRONT SETBACK <br />USE <br />110 <br />APPLICATION <br />BY <br />SIDE SETBACK PlANCNECK NUMBFP /� PLAN CHECK FEE <br />V_ FEE 7&_ RECEIPT NO, <br />VACANT BITE rj rIES VALUAHON FEE <br />OYESGYES nNo <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />