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thI I I rI r1rr9 <br />everett <br />';ONS i RUCTION' <br />PERMIT <br />PERMIT NO. 16165 <br />CITY HALL 259,8745 <br />EVERETT,WA99201 DR COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Boyden Realty, Inc. <br />1429 Broadway <br />Everett_ <br />98201 <br />252-1166 <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE <br />Gary Parkinson <br />527 Medical Dental <br />Bldg. Everett 98201 <br />252-2153 <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE I <br />J & D Builders <br />1429 Broadway <br />Everett 99201 <br />252_1166 <br />#.InanT223J0 <br />_ <br />MELHANICAL CONTRACTORI <br />ION468 Goa-% P <br />MAIL ADDRESS <br />CRY <br />- <br />ZIP <br />PHONE LICENSE I <br />;F;A <br />h <br />99c99 <br />A155 - <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE <br />White Coast Plumbing <br />119 Avenue A <br />Snohomish <br />98290 <br />568-6155 <br />CLASS OF WORK�y <br />`$NEW ❑ ADDITION <br />❑ ALTERATION ❑ REPAIR <br />❑ DEMOLITION ❑ FENCE <br />❑ SIGN <br />❑ WOOD STOVFJFIREPLACE INSERT <br />f 41, 000 <br />DESCRIBE WORK <br />Construct Single Family Residence Basic Plan C <br />PROPOSED USE OF BUILDING <br />SFR <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE 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 />PERFORMA E OF CONSTRUCTION. <br />SIGNATURE TRACTOR OR AUT ORIZEO T DATE <br />X <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />pp <br />LOT-51LBLOCK_OF Sunridge niviSien III <br />-- <br />JOB ADDRESS <br />216 - 93rd St._ S.F <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF EQUIPMENT FEE <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />2 <br />WATER CLOSET (TOILET) <br />n <br />AIR COND. UNITS - H.P. EA. <br />1 <br />BATHTUB <br />REFRIGERATION UNITS - H.P. EA. <br />2 <br />LAVATORY (WASH BASIN) <br />BOILERS - H.P. EA. <br />1 <br />SHOWER <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />1 <br />KITCHEN SINK t DISR <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />1 <br />DISHWASHER <br />WALL HEATERS - B.T.U. M <br />0 <br />LAUNDRY TRAY <br />n <br />UNIT HEATERS -- B.T.0 M <br />1 <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />1 <br />WATER HEATER <br />2 <br />CLOTHES DRYERS <br />0 <br />URINAL <br />VENTILATION FAN <br />0 <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />0 <br />FLOOR DRAIN <br />AIR HANDLING UNIT - C.F.M. <br />VACUUM BREAKERS <br />L <br />STOVE - WOOD <br />0 <br />ROOF DRAINS - RAINLEADERS <br />METAL FIREPLACE & CHIMNEY <br />SINK (SERVICE - BAR, ETC.) <br />FIREPLACE U,SERT <br />HEAT PUMP <br />SUB TOTAL f <br />SUB TOTAL f <br />PERMIT f <br />PERMIT f <br />TOTAL FEE $1 <br />20 <br />0 <br />TOTAL FEE i <br />SIDE YARD SETBACK <br />STREET SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />6/16165 BASIC <br />PLAN <br />FEE p <br />CHECK FEE <br />RECEIPT NO. <br />USE ZONE <br />R-1 <br />LOT AREA <br />VACANT SITE <br />RYES NO <br />FEES <br />VALUATION <br />FEE <br />ldg. Code SurchargiYUJIBM <br />Gede�ur�o <br />Bf <br />AN 000RI11D11d <br />5 <br />TYPE OF CONST. <br />XX y-N <br />OCCUPANCY GROUP <br />R-3 <br />NO, OF DWELLING UNITS <br />1 <br />Y <br />BUILDING <br />Q�i <br />24 <br />. 3 <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />B BRCH <br />em <br />20 <br />0 <br />FIRE ZONE <br />BASEMENT <br />REOUISRED KLERS <br />YES NO <br />MECHANICAL <br />.50 19 <br />0 <br />X"111% Driveway <br />Do 20 <br />00 <br />APPROVALS <br />By <br />DATE <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY <br />SIM3 P) { <br />�� <br />2. BUILDING PLANE <br />TOTAL <br />100WARP <br />,50 <br />— <br />3,FIRE HYDRANT <br />A. FIRE PROTECTION SYSTEM <br />PERMIT VALIDATION �yy��r p2mAA�� <br />WHEN PROPERLY VALIDATED IIN E11M1'! THIS IS YOUR PERMIT <br />Sm $30.00 <br />BFOIII s=.00 <br />CWCK $738r50 <br />S. GRADING <br />8. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEAL IH DISTRICT <br />APPLICATION ACC. BY <br />MM <br />PLANS CHECKED BY <br />STG <br />APPR. FOR ISSUANCE BY <br />LC <br />ADDRESS FILE <br />