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� APPLICATI"�N FOR CONSTRU6`�IBN PERMl� � <br /> TO BE COMIPLETED IN BLACK INK—PLEASE PRINT <br /> . CITY OF EVERETT BASIC NUMBER: <br /> n n <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS O ELECTR�C O <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION �it BUILDING ❑MECHANICAL �7 PLUMBING ❑ SIGN <br /> ONTJER MAILAUOFE55 CITV LP PIIONE <br /> SELECT HOMES, INC. 237 ELM ST. , EVERETT, WA 98203-1921 (206) 258-1503 <br /> TEIUNT IMII�DORE55 CITV ZIP PIIONE <br /> ARCHITECTORDESIGNER AUILADDRESS CITY ZIP PHONE <br /> GENEMLCONTMLTOR MAILAD�RESS CITV ZIP PIIONE SiQEIILEN5E1 <br /> SELECT HOMES. INC. 237 ELM ST. , EVERETT. WA 98203-1921 258-1503 SE •LF•CHI110KN <br /> MEGNMIICKCONTPACTOfl MARADOflE55 diY 21P PHONE STATELICENSEI <br /> PLl'HINGCONTRACTOP MAL�DUPESS CITY 21P PIIONE STATEUGENSEI <br /> CONTMCT VPICE OF WIXiN <br /> 4�0�� <br /> OESGRIBE WORN�NO SOUAPE FOOTAGE INVOLVEO CONTACT PERSON M!D P11QlIE NO. <br /> CONSTRUCT SZNGLE FAMILY RESZDENCE <br /> ' I HEHEBV CERTIFY THAT I HAVE flEAD AND EXAMINED THIS <br /> rnoroseo use oF euwou�c APPLICATION/.ND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> SINGLE FAMILY DWELLING PROVISIONS OF UWS AND ORDINANCES OOVERNING THIS TYPE OF <br /> LEMIDESCRIPTIONOFPROPEFTV�SlqWNBELOWOflATTACHTWOCAPIES) , ,�� ;, WORK WILL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTINO OF A PERMIT OOES h0T PRESUME TO GIVE <br /> �oi �� eiocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> HANABROOK DIVISZON 4 OTIiER STATE OR LOCAL LAW flEGULATIN(i CONSTRUCTION OR THE <br /> �' PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEU BY THE <br /> - •'� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAflCEL TA%I.D.NUMBEN / CONTRACTO S LAW ��27 RCW AND 296200 WAC. <br /> �y �� S�LEC HOM� � INC. <br /> CONSTHUCTIONL011NLENDER,ADDPESS.TELE1 .1cNUMBc'R - ' ' (] <br /> SEATTLE MORTGAGE� SEATTLE� WA Y; L � r�7 <br /> PIiOJECT ADDRESS wru wrt <br /> cmexsrrtss icer�sc • <br /> PLUMBIN6 � � MECNAWCAL <br /> NO. TYPE OF FlXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> 3 WATER CLOSET(TOILET) � � NC—MiNDLG UNITS--H.P. <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � - ����i �- UNIT HEATERS--B.LU. M ; <br /> � -.-. SHOWER ' ' CLOTHESDRYERS <br /> � KITCHEN SINK 8 DISP � i VENTIUTION FAN ; <br /> � DISHWASHER RANGE HOOD <br /> UUNDRY TRI1Y � ;'� �•- '� WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOV[ � <br /> � URINAL ' METAL FIREPLACE(WOOD BURNING) � <br /> - DRIt" � ''WNTAIN � -� :��i��•. FIHEPLACE INSERT ; <br /> FLOG .. . � HEAT PUMP � <br /> �` � BACKFWWPREVENTERS ; GASPIPIN(i ; <br /> � '! ROOF DRAINS--RAINLEADERS � � EXHAUST FAN � <br /> � �SINK(SERVICE—BAR,ETC J ' � <br /> � <br /> i � <br /> � � <br /> � � <br /> � � _ <br /> i � <br /> SUB TOTAL S � SUB TOTAL 5 ' <br /> PERMIT S � PERMIT S � <br /> TOTALFEE S � ' TOTALFEE E <br /> FOR OFFlCE USE ONLY: <br /> FIiONTSEIBACN REMSETBIICK SIDESETBACK PIMIGHECNNUAIBER FEE RECEIPTNO <br /> � � �� �� <br /> useza+ totuie� v�c�wts�re FEES VALUATION FEE <br /> �L g� C�YES ❑ NO BUILDING 8� 23Z. �J 'cS�� <br /> lYPEOfCOMSL �.aFSTORIES amMNrtY 1q.00�illMGLNrIt 7 � <br /> � Z � PLUMBIN(i ' �j <br /> 517EOF&Dfi. FHiESPPIWQE115pE0'D filSEMEMT MECHANICAL � <br /> � I�o Sf Y � � ❑ YES � NO �GG � L� <br /> pCCUPNICYIO�D FIRENAfWREo'D HEIGMTLN11U7qN� A��TIONALPLANCHECK <br /> NJ OTHER ��j �L:T <br /> REASaM <br /> STATE BUIIDING SUFi(:lU�RGE �Z <br /> rrt�er a�ws�wP VEDBY CITYOfEVEflEI'T pue��cwoaus ,�(; ;� <br /> �k} LOCAL SALES <br /> DA1F � � g3 TAl(COUE IS 3105 *mK � <br />