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t,PPLICATION FOl. <br />CITY'.'°""°CITY or CONSTRUCTION <br />everett PERMIT <br />TO BE COMPLETED IN BLACK INK - PLEAFE FPINT <br />BUILDING DEPT. <br />259.8745 ❑ COMBINATION ® BUILDING ❑ MECHANICAL <br />V <br />❑ PLUMBING ❑ SIGN <br />IPA'NER <br />Boyden Realty, Inc. <br />MAIL ADUOFSS <br />1429 Broadway <br />.:Iw <br />Everett <br />Z11, <br />98201 <br />PHONE <br />252-1166 <br />an6NNEc T OnnESwNEn <br />Cary Parkinson <br />MAIL ADOPTERSCITY <br />527 Medical Dental <br />TY <br />Bldg. Evetett <br />ZIP <br />98201 <br />1,110,4E <br />252-2153 <br />OENEnALCOT:',ACTOR <br />.1 d D Builders <br />MAIL AnnnESS <br />1429 Broadway <br />CITY <br />Everett <br />RP <br />98201 <br />PHONE <br />252-1166 <br />IICENSE• <br />223-01 <br />MECIIANICAL CONTOACFOB <br />RAIL AGGRESS <br />CITY <br />ZIP <br />PHONE <br />JDBU1223JO <br />LICENSE <br />wNWhiteNCoast Plumbing <br />MAIL <br />119ADDRESS <br />Avenue A <br />Snohomish <br />98290 <br />P1RINE <br />568-6155 <br />LICENSE E <br />LABS OF WORK <br />9 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLANSERT <br />_ ❑ BUILDING <br />RELOCATION <br />VALUATION OF WORK won OF MATERIALS PLUS LASON <br />UESCSISE WORK <br />New Single Family Residence -Plan 14 <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 />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THISTYPE <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 />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF, .oT UnACTcoh on AUTHORIZED ACy <br />I <br />LEGAL DESCRIPNON Or PnoPEmY IBIIUWN BELOW OR ATTACU roan COPIER <br />60 SUnridge Div. III <br />LOT-_WOCK _OF <br />- <br />211 - 93rd St., S.E. Everett <br />PROJECT ADORl SS <br />APPLICAN rS COY BUSINESS LICENSE NO <br />PLUMBING <br />_MECHANICAL <br />NO. <br />TYPE OF FIXTURE <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET TOILE <br />AIR COND. UNITS-H.P. EA. <br />DATIOUS <br />nEFRIGEnA110N UNITS-H.P. EA <br />LAVATORY WASH BASIN <br />BOILERS-H.P. EA <br />SHOWER <br />OAS FIRED A.C. UNITS -TONNAGE EA <br />KITCHEN SINK • DISR <br />FORCED AIR SYSTEMS-B.T.U. M EA <br />DISHWASHER <br />WALL HEATERS-BT.U. M <br />LAUNDnYTRAY <br />UNIT HEATERS-B.I.U. M <br />_ <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />_ <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />_ <br />AIR HANDLING UNIT- C.F.M. <br />VACUUM BREAKERS <br />STOVE <br />_ <br />ROOF DRAINS-RAINLEADEns <br />METAL FlnEPLACE E CHIMNEY <br />SINK (SERVICE -BAR, ETC.) <br />WOODSTOVE/FIREPLACE INSERT <br />BUD TOTAL <br />SUBTOTAL • <br />PERMIT t <br />PER • <br />_ <br />TOTAL FEE IT <br />_ <br />_ <br />_ <br />__ TOTAL FEE <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />ETai <br />