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A�PLICAT'�N FOR CONSTRUQ'-'ION PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> . CITY OF EVERETT BASIC NUMBER: .33 <br /> n n <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC D � <br /> 259-BB10 <br /> ❑ DEMOLITION C 1 COMBINATION �Gi BUILDING ❑MECHANICAL ❑PLUMBING fl SIGN <br /> OWNER M�ILADDRE55 p�ry I�p p�p�yE — <br /> SELECT HOMES, INC. 237 ELM ST. , EVERETT, WA 98203-1921 (206) 258-1503 <br /> TENANT IM0./�DDRESS CI7V 21P prypNE <br /> AflCHRECTOHDESIGNEfl MAllA0DNE55 CITY ZIP PqpNE <br /> GENEPALCONTMCTOP AUILADDRESS CITY ZIP PlqqE ST�TELICENSEI <br /> SELECT HOMES INC 237 ELM ST EVERETT WA 9820 —�q � ��a_� sna SFrFrur� tnxN <br /> MEClWIICQLONTR�CTOfl AUIIGDDPE55 CITY ZIP p�pryG STATELICENSE� <br /> PLUMBINGCONTMCTOR MAII AODRE55 CITY 21P PHONE STAiE UCENSE 1 <br /> CONTHACT PRICE OF WORK <br /> 4�0�� <br /> [`ESCRIBE WORN�ND SOUARE FOOT�GE INVOLVED CONTACT PEfl50N AND P110NE NO. <br /> CONSTRUCT SINGLE FAMILY RESIDENCE <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPQSED USE OF BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> SINGLE FPMILY DWELLING PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �ok�o,!�)S�CRIPTqNO:'PFOPERtt�S110WNBELOWOflATTAGHTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oi�-Y� e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � HANABROOK DIVISION 4 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> - - � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> PM:EL LV(I.O.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> S�LEC HO S, INC. <br /> CONSTPUCTIONLOANIENDEN.ADORE55,TELEPHONENINABEp - ' <br /> SEATTLE MORTGAGE, SEATTLE� WA Y: �D—/ S g � <br /> PNOJECT AD E � sw:w*we o��e <br /> 30l �'i Gc� 6� . <br /> cmeusw¢ss�K[raE w. <br /> PLUMBINfi ' � MECFIANICAL <br /> ►M.1. TYPE OF FlX7UNE OR REM FEE 110. TYPE OF EGUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) / � A!C—NHNDLG UNITS—H.P. <br /> 1 BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> � LAVATOflY(WASH BASIN) � - i ' " UNIT HEATERS—B.T.U. M <br /> 1 SHOWER � � CLOTHESORYERS i <br /> KITCHEN SINK 8 DISP � � ; VENTILATION FAN ; <br /> DISHWASHER � � RANGEHOOD / <br /> LAUNDRY TRAY ; � WATER HEATER � <br /> CI.OTHES WASHER / i WOOD STOVE <br /> URINAL � FIETAL FIREPLACE(WOOD BURNING) <br /> ORINKING FOUNTAIN � � FIREPUCE INSERT <br /> FLOOR DRAIN i HEAT PUMP T— <br /> BACKPLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> �SINK(SERVICE—BAR,ETC.) � <br /> � <br /> � � <br /> ti� <br /> T <br /> SUB TOTAL S � SUB TOTAL $ ' <br /> PERMIT S � PERMIT $ <br /> TOTAL FEE E ' TOTAL FEE $ <br /> FOFi OFfICE USE ONLY: �3, c� <br /> FNONTSETBACN REAHSETB4CK SIDESETBACI( PLANCHECNNUMBEp FEE RECEIPiNO. <br /> 3 � � <br /> , <br /> usezoee LOTAREA v�enNrsrte FEES VALUATION FEE � <br /> �-2 y L�FYES ❑ NO BUILDING 3Z 'SU <br /> ttreacows7. rw.oFsroni s ocwruc. w.ow�u�wcurn <br /> _� z i ��Ma,� ; a� <br /> SIZE BLD6. FIRE SPRINNlERS REO'0 6�SEMENT MECHRNICAL �� � <br /> ,7 ❑ YES � NO � — <br /> ADDITIONAL PLAN CHECK � <br /> . OCCUPMlLYlMO FIflE/LLAqMREO'D MEIGHTIWIT�T�IqON � � �} <br /> /S%� S'F C's ZV I / � <br /> �� '� OTHER f �� _T_ <br /> STAiE BUILDMX'SURCHARGE �—Q <br /> WTNlE BY 7��^�_yED BY CIiY OF EYEBETT WJ��(,'VJORIfS _ � �D <br /> •J F LOCAL SAlE3 <br /> w.e � � • g 3 iAl(CODE IS 9105 roiu � , ; S- <br /> r <br />