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TheLerrir,I",ONSTRUCTIOI`' <br />everett PERMIT PERMIT" NO. <br />CITY HALL 259.8745 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Boyden Realty1 inc. <br />1429 Broadwav <br />Everett <br />98201 <br />252-1166 - <br />ARORITECL OR DESIGNLR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Gary Parkinson <br />527 Medical -Dental Bldg. Everett <br />98201 <br />252-2153 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE 4 <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 A <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 />98290 <br />568-6155 _ <br />CLASS OF WORK <br />fig NEW ❑ ADDITION <br />❑ ALTERATION ❑ REPAIR <br />❑ DEMOLITION ❑ FENCE <br />❑ SIGN ❑ <br />WOOD STOVEIFIREPLACE INSERT <br />45,000.00 <br />Oonstruct Single Familv Residence - Basic "A" <br />PROPOSED USE OF BUILDING <br />Single Family Residence <br />APPLICAT ON CERTIFY ANDTHAT KNOW THE SAME TO BE I HAVE READ AND EXAMINED <br />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 TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCCONSTRUCTION. <br />SIGNATURE OF RACTOR OR AUTHQRI2ED AGE DATE <br />X rY— ;7yy- Y <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT 61 BLOCK -OF Sunrid a Div. III <br />JOB ADDRESS <br />213 - 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 />_ <br />WATER CLOSET (TOILET) <br />AIR COND. UNITS - H.P. EA. <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />_ <br />LAVATORY (WASH BASIN) <br />an <br />BOILERS - H.P. EA. <br />SHC WER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />KITCHEN SINK 6 DISP, <br />2 <br />00 <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />DISHWASHER <br />2 <br />00 <br />WALL HEATERS - B.T.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />2 <br />00 <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />2 <br />00 <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 - RAINLEADERS <br />METAL FIREPLACE 6 CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />1 <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL f <br />20 <br />0 <br />SUB TOTAL f <br />22 <br />5 <br />_ <br />PERMIT f <br />PERMIT f <br />TOTAL FEE f <br />20.00 <br />TOTAL FEE f <br />22 <br />SIDE YARD SETBACK <br />PRO <br />STREET SETBACK <br />PRO <br />REAR YARD SETBACK <br />PRD <br />PLAN CHECK NUMBER <br />86/16171 - Basic <br />PLAN <br />FEE -0- <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />R-1 <br />LOT AREA <br />VACANT SITE <br />xYES NO <br />— <br />FEES <br />VALUATION <br />FEE <br />BldB • Code Surcharge <br />Energy rods Surc <br />BUILDING <br />O— & <br />TYPE OF CONST. <br />V-N <br />OCCU ANCY� <br />R-3 <br />NO. OF OWELLING UNIT6 <br />1 <br />19 <br />.0>8 <br />9m 00001m <br />51* <br />SI]�E F BL <br />^-_� - i�52 ARA1 <br />NO. OF STORIES <br />MAX, OCC. LOAD <br />4 <br />PLUMBING <br />20 <br />00 <br />FIRE ZONE <br />BASEMENT <br />FIRE <br />EOUIREINKLERS <br />YES NO <br />MECHANICAL <br />B <br />1.30 22 <br />SO <br />N* P Driveway _ <br />PENALTY <br />- <br />TOTAL <br />A 20 <br />00 <br />APPROVALS <br />BY <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />3 Ia1 <br />,pp <br />2. BUILDING PLANS <br />ML <br />9.50 <br />i <br />�^' % <br />S. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED TIN THIS IS YOUR PERMIT - <br />WATER $60.00 <br />N00025743 , <br />SEWER $30 00 <br />M 111 $330.00 <br />DIED( $759.50 <br />&GRADING <br />6. DRAINAGE <br />- <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />S. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />S.T.G. <br />APPR. FOR ISSUANCE BY <br />L.N.C. <br />ADDRF' Illy <br />