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, APPLICAT�'``N FOR CONSTRUC'�ION PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BASIC PLAN: CEDAR (CITY N0. 10D ) <br /> BUILDING DEPARTMENT HEATING SYSTEM: fiGAS O ELECTRIC ❑_ <br /> � . <br /> 259•8810 <br /> i I DEMOLITION y�l COMBINATION ❑ BUILDING ❑MECHANICAL I I PLUMBING I I SIGN <br /> ONMER MAILAUDRFSS 'CITY ZIP� PlIONE <br /> SELECT EIOMES, INC. 237 ELM ST EVERETT WA 98203 258-1503 <br /> iEWWI MAILAODPE55 GTY 21P PMONE <br /> AHCMITECTOfiDE51GNEN WM1i1Dp{IE55 G1Y ZIP PIIONE <br /> GENEMLCONTRACTOIi WILADD{iESS GTV 21P PIIONE SIATEIICENSE� <br /> SELECT HOMES, INC. 237 ELM ST EVERETT WA 98203 256-1503 SELECHI110KN <br /> MEC1WlILALCONTPAGT01i M�ILADDf1ESS CITY ZIP P110dE S7ATElICENSE� <br /> PLUMBNIOCONTRIICTON 1MIL�DDRE55 LITY ZIP PMONE SInILliGN5l1 <br /> GONTMCT P1710E OF WOR1c <br /> 40000 <br /> UE5CflIBE WOPK AND SOUAPE FOOTAGE INVOLVEU �p1�TAGi PEPSON AND PHONE NO <br /> SFR RANDY CLARK 256—�503 <br /> I MEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> SFR PROVISIONS OF UWS AND ORDINANCES GOVERNING 7HIS TYPE OF <br /> �ec�uo¢sc IPTIONOFPHOPEHTY�SHOWNBELOWq7ATTACN7NqCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � �� wt �� eiocK � HANABROOK DIV q_ NOL THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> , OTMER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEO BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICN <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> YAqCEI T�%I.0 NUMBEN �ippGrpqg LAy�tg,p�g�yy_pND 29G200 WAC. <br /> LECT tiUN1�S 1NC: <br /> � LONSTHUCTION LWN lENOEN,�ODNESS,TEIEPHONE NUMBEfl <br /> Y bv: � _J- �L�- .Cy'9� <br /> PROJECT ADDRESS p /� wwmnc - oui <br /> SS� / �ST // " L� cirreus+�[ssiccnscw — — <br /> PLUMBING YECHANICAL <br /> NO. TYPE OF FU(TURE OR REM FEE N0. TYPE OF EUUIPMIENT FEE <br /> WATER CLOSET�TOILET� � � NC—A/HNDLG UNITS—H.P. <br /> BATHTUB ' FORCEDAIHSYSTEMS—B.T.U. M E.A. � <br /> _i_— <br /> LAVATORY(WASH BASIN) � �NIT 1iEATERS—B.T.U. M <br /> SHOWER � � CLOTHES DRYERS <br /> KITCMEN SINK 8 DISP � ; VENTILqT10N FAN � � <br /> 1 DISHWASHEH � RANGE MOOD ��—' <br /> LAUNDRY TRAV ; WATER HEATEF �� <br /> CLOTHES WASHER � WOOD STOVE - <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) <br /> _ DRINKING FOUNTAIN � FIREPUCE INSERT <br /> FLOOR DRAIN � HEAT PUMP —r <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ! ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> �, SINK(SERVICE—BAR,ETC.) ; � <br /> � <br /> _. <br /> � <br /> � <br /> � — <br /> SUB TOTAL S ; SUB TOTAL $ <br /> , _ PERMIT S � PERMIT $ <br /> TOTAL FEE f ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: ` <br /> �1�lNi1SLIBI�CN IiLNIStIWCIt SIDESETFI�CI( PIANCHECKNUMBEq FEE IIkLL1Y1NU <br /> _� ' _ � ' � � � ��y�� J� 9 sa <br /> uti�ptup� im�n�n VAC/�NI SIIE FEES VpLUATION FEE <br /> /r �L Q ❑ YES ❑ NO g�ILDING Z 2� '�/ Q �OC <br /> IYPf OICON51 NO OF STORIES rcavu[r x0 upkLLWcunif �� 1 iJ- <br /> _�_ __ � ,� PLUMBING <br /> 512EOF&DG I�iRLSPN�NICLEP5HE00 BASEYENT � <br /> �' SS`+'A(j Kp ❑ YES [Df�.JD MECHIINICAL —L_— <br /> � —9p� <br /> OCCUPMICV LOAD FINE AIAqM flEOD HEIGMT LIMITATION ADDITIONAL PUN CHECK <br /> � 'O O Z�� OTNER ��/(/ �G � C'Cl <br /> RE�SON _ <br /> SUTE BUILDING SURCH�RGE —�J=/\ <br /> iN1A1fE BY PLANS�PPROVED6Y CITY OF EYERETT PUBLIC WORKS SJ <br /> �J I� LOCAL SALES ���� <br /> onre � 5 9 TAX CODE IS 3105 Toi�� ��� ��-D <br />