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m.EYFFr..R APPLICATION FOh- FYPiFK <br />CITY OF CONSTRUCTION <br />everett PERMIT <br />TO BE COMPLETED IN BLACK INK- PLEASE PRINT <br />BUILDING DEPT <br />259.8745 ❑ <br />COMBINATION © BUILDING ❑ MECHANICAL <br />❑ PLUMBING ❑ SIGN <br />OWNED <br />Boyden Realty, Inc. <br />MATt ADDRESS <br />1429 Broadway <br />CITY <br />Everett <br />Tip <br />98201 <br />rULme <br />252-1166 <br />ARCHHFCt OR DE9011ER <br />Gary Parkinson <br />MAIL ADDRESS <br />527 Medical Dental <br />City <br />Bldg. Everett <br />tip <br />98201 <br />PHONE <br />252-2153 <br />GEN' RAL CONIDA;TOD <br />.1 6 D Builders <br />MAIL ADDRESS <br />1429 Broadway <br />CITY <br />Everett <br />ZIP <br />98201 <br />PHONE LICENSE <br />252-1166 223-01 <br />MECHANICAL CONTP"WOR <br />MAIL ADDRESS <br />City <br />ZIP <br />PHONE LICENSE <br />JDBUI2.23.10 <br />PLUMOINOC ONTRACIOR <br />White Coast Plumbing <br />MAIL ADDRESS <br />119 Avenue A <br />CITY <br />Snohomish <br />ZIP <br />98290 <br />PHONE LICENSE <br />568-6155 <br />`i NEW ❑ ADDITION ❑ A,TERATION ❑ REPAIn ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSEnT ❑ BUILDING RELOCATION <br />VALUATION OF WORK ICOBT Or MATEmALe PLUS LABORS <br />Of SCRIBE WODK <br />New Sinele Family Residence - Plan <br />USE Of BUILDING — <br />SFR <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONSOF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED WITH 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 OF' <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />BIONAtURE rCON I IOROR UINO ZEDAOEI DATE.i S <br />x 1Q(�� E°G �j <br />t EGAI DESCRIPTION OF PROPERTYISHOWN BELOW ORA I I Act] rOU"COPIEO1 <br />Sunridge Div. III <br />lot 58 BLocK_Or <br />-- <br />216 - 93rd St., S.R., Everett <br />PROJECT ACR RESS <br />ArrLICANfS CITY RUSINE SS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OP FIXTURE <br />FEE <br />100-7 <br />TYPE OF EOUIPMENT <br />FEE <br />_ <br />CLOSET (TOILET) <br />AIR COND. UNITS-H.P. EA <br />_WATER <br />OATHTUB <br />RErR10ERAT10N UNITS-H.P. EA- _ <br />LAVATORY (WASH BASIN) <br />SHOWER <br />_ <br />BOILERS-H.P. EA <br />OAS FIRED AC_UNITS-TONNAGE EA <br />_ <br />KITCHEN SINK E DISP. <br />FORCED AIR SYSTEMS-B.T.U. MEA <br />DISHWASHER <br />WALL IIEATERS-B.T.U. M <br />LAUNDRYTRAY <br />_ <br />_ <br />UNIT HEATERS-B_T.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />VENTILATION FAN <br />_URINAL <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 />_ <br />_ <br />METAL FIREPLACE S C„IMNEY <br />SINK [SERVICE-BAEL ETC.1 <br />WOODSTOVEIFIREPLACE INSERT <br />SUBTOTAL <br />BUS TOTAL • <br />PERMIT • <br />PERMIT _ • <br />TOTAL FEE • <br />___ TOTAL ITEE.._ <br />EROIII SE IBACK <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />BY <br />� V� <br />SIDE SETBACK <br />VACANT SITE <br />LIVES LINO <br />LOAD <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />//�L PLAN CHECK FEE <br />G EEE .Ay RECEIPT NO <br />VALUATION FEE <br />To <br />