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� � APPLICATCIN FOR CONSTRUC�ION PERMIT � <br /> TA BE COMPLETED IN BLACK INK�LEASE PRINT <br /> 3ASIC PLAN: CEDAR (CITY NO. IOD ) <br /> HEAiING SYSTEM: �GAS 0 ELECTRIC O <br /> BUILDING DEPARTMENT , , <br /> 259•8810 <br /> . I 1 DEMOLITION IXI COMBINATION ❑ BUILDING ❑MECMANICAL I I PLUMBING I i SIGN <br /> OY/NER 14�1�00PE55 CITY ZW PIqNE <br /> SELECT HOMES, INC. 237 ELM ST EVERETT WA 98203 258-1503 <br /> iEIWIT YALADq1E55 p�y j�p p�p� <br /> AqCNITECTORDESICapER WLADDqE55 GfY ZW VlqqE <br /> GEHEMLCp1iMCTOR WLMOqES$ GfY IIP PIqqE SUTELICENSEI <br /> SELECT HOMES, INC. 237 ELM ST E\7ERETT WA 98203 258-1503 SELECHI110KN <br /> MEC1W11CKCONTHACT011 IMIIiWRESg GTY ,',IP pryptlE St�TEtICENSE� , <br /> PIUMBMOCANTMC70R M�lA0DRE65 CITY 21P %qllE SIAIEIICENSE� . <br /> CONTRACT PN10E O � ' <br /> 4���� <br /> OESd11BE W011K ANO 50U�PE FODTAGE MNOLVED CONTACT PEIi5p1 NID P110NE Iq. <br /> SFR RANDY CLARK 258-1503 <br /> I NEREBY CERTIFY TMAT I HAVE READ AND E%AMINED THIS <br /> Pfi0i�5[D USE OF BUKDING MpLICATION ANDi(NOW THE SAMt lU BE TRUE AND CORRECT.ALL <br /> SFR PROVISIONS OF LAWS AND ORDINANCES GOYERNING TMIS TYPE Of <br /> �eau�oe qpTqNOFPHOPERTY�51qWHBELOWpqAiT�L11TWOCOPlE3� WORK WILL BE CAMPLETED WITM WHETHER SPECIFIED HEREIN OR <br /> �pT 3 ��K � HANABROOK DIV Q_ �T. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> i AUTHOflITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTNER STATE OR LOCAL UW REGUUTING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ' OWNER OF THIS PflOPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PMCEL T1N!1 D MMABEH CDNTp�cipps 27�C�AND 296200 WAC. <br /> SELE(;T H <br /> CONSTRUCTqN IOAN IENDEN.ADDRES6.TElEP110l/E NIMBEp � <br /> b : � —� 3 <br /> reaecr�oonEss SS 3 S �,,,t� a,E ' — <br /> �.w���K�,� <br /> �uwallo wEc►�wcn� <br /> N0. TYPE OF flXTURE OR REM FEE N0. TYpE OF EOWPMENT FEE <br /> WATER CLOSET(TOILET) ' � NC�IIIIiNDLG UNITS—H.P. <br /> BATHTUB ' FORCED AIH SYSTEMS—B.T.U. M E.A. � <br /> UVATORY(WASH BASIN) � - UN17 MEATERS—B.LU. M <br /> �, SHOWER � � CLOTMES DRVERS <br /> ' KITCHEN SINK 8 DISP � � ; VENTIUTION PAN <br /> DISHWASHER � RANGEHOOD T- <br /> LAUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL ' METAL FIflEPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN � FIREPUICE INSERT <br /> _ FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; �g p�p��, <br /> ROOF DRAINS—RAINLEADERS � E%HAUST FAN <br /> �SINK(SERVICE—BAR,ETC.) � <br /> i <br /> � � <br /> � <br /> � <br /> � <br /> SUB TOTAL S ; SUB TOTAL S <br /> PEflM1T Z � PERMIT s <br /> TOTALFEE S ' TOTALFEE S <br /> FOR OFflCE USE ONLY: <br /> FRONT��, REMSETB�CN 5�JBACI( PlAMG1ELKNUMBER FEE�� f1EGE�/G��D <br /> �CJ <br /> use l07 MEA �,[ vecuy+ s�te FEES VALUATION FEE <br /> Z 7 Y' B�YES ❑ NO ��� <br /> _ rvacacoxst. no.oFstorues acnrrcr �o.aowua�u.n ' 7 � — <br /> �i_ <br /> — � P�UNBING <br /> S12E OF&DG.t fIRE SFRINNLEflS flE0'D &15EYENT / MECHANICAL <br /> IvZ� sSF 4a o n res ��o <br /> OCCUPANCY OAD FIREAIARMREO'0 HE16HTLIMITI�TION �DITION�LPLANCHECK �'_ <br /> � onieR DO/U Q � <br /> REASON <br /> . STATE BUILDING SURCHARGE <br /> INTN(EBY PLAHSAPPROVEDBY CITYOFEVEHEIT pUQ��`yyppK$ /IO; <br /> J I� LOCAL SALES L <br /> o�ie Z 9 q3 TAX CODE IS 3105 mTw <br />