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. . APPLICATI'°N FOR CONSTRUC''lON PERMIT � <br /> TO B:�;OMPLETEO IN BUCK INK—PLEASE PRINT <br /> BASIC PLAN: MAPLE (CITY NO. 10 7 ) <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS O ELECTRIC ❑ <br /> 259-8810 <br /> I� DEMOUTION p0 COMBINATION ❑ BUILWN�i ❑MECHANICAL L"I PLUAABING LI SIGN <br /> owr�a uu�woness cm zr eNor� <br /> SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 <br /> TEWWT wk�ss cm zw n�or� <br /> AFICNITECTOi10E5�GNER WILADOpESS CRY 21P P110NE <br /> GENEMLCONTMCT(Mi IML�DOpE55 CffV ZIP %IpqE STATELIGENSEI <br /> SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 SELECHI110KN <br /> MECN�NICKLONTMCTOfl Wl11DOf1EfiY CIIY TY P11011E ST�TFUCENSE/ <br /> PLUMp111fiCONTMCT011 WKMORESS (',Iry Ip PlIp�1E SiA7ELIGEN5E1 <br /> fANTMCT P1110E OF WqYt � , <br /> 90000 <br /> OESCN/E WOIIK NO BOIWIE FODLIOE MVOWED CCNq1CT PER+ON AND M10NE MD. <br /> Rand Clark 258-1503 <br /> 1 HEREBV CERTIFY TNAT � HAVE READ AND EXAMINED THIS <br /> P�����w�� APPUCATION AND KNOW THE SAME TO BE TNUE AND CORRECT.ALL <br /> PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS iVPE OF <br /> �auoescnwrionoFrnor�qTr�s�qwHae�owoN�rT�u+iwpcor�s� � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �pT� �� � HANABROOK DIV N �NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTMER STATE OR LOCAL UW HEGUUTING CONSTRUCTION OR THE <br /> - PERFORMANCE OF CONSTRUCTION.THAT I AM AUTFIORIZED BV THE <br /> OWNER OF THIS PpOPERTY TO PERFORM THE WORK FOR WNICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PMCEL TN(ID.NUMBEN �Sjry_q�CT 27 aCY�LAND 296200 WAC. <br /> SEI+ECT iNC <br /> GONSTRUCTqN lWN lENOER./iWPESS.TElEP110NE NlMlEp <br /> PROJECT AODRESS rawiu� � � 2— <br /> ar[ <br /> S cmws.<uuawa�o. -� <br /> YLUAABIIIf1 IIECf1A1MCAL <br /> NO. TYPE OF flXTURE Op ITEM FEE N0. TYPE OF EWIPMENT FEE <br /> 3 WATER CLOSET�TOILET) � � A�NHNDL6 UNIT�FI.P. <br /> BATHTUB ' FORCED AIR SVSTEMS--B.T.U. M E.A. <br /> 3 LAVATORV(WASH BASIN) ' • - � � UNIT MEATERS--B.LU. M <br /> y SHOWER � ' � CLOTMES DRVERS <br /> ], KITCHEN SINK 8 DISP � � � ; � VENTILATION FAN � <br /> 1 DISHWASHER � 1 RANGE HOOD �--`— <br /> LAUNDRVTRAY ; WATER HEATER <br /> ], CLOTHES WASHER � • WOpp STOVE ' <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) �T <br /> �LL� <br /> DRINKING FOUNTAIN � ' FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; �g p�p{� � � <br /> ROOF DRAINS—RAINLEADERS � � ExHAUST FAN <br /> -SIKK(SERVICE—BAR,ETC.) ' <br /> � <br /> � 4� <br /> � <br /> � <br /> � <br /> _ SUB TOTAL S ; SUB TOTAL S c <br /> PERMIT = � PERMIT S <br /> TOTALFEE S ' TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> I�qONTSETB�C� REMSETQA('J{ SIDESFTgklf plµCllEqfq�Jl�iEfl FEE .� PEGLMI <br /> ' � JCJ DG� ) <br /> usezar� �oTu�e� wc�nT FEES - VALUATION FEE <br /> —� Q ES d NO BUILD�NO <br /> r a cast .oF sroa s occ�w�c� w a o.�usum `j �; - <br /> _ 'L M0� I PLUMBING <br /> 51ZEOF8�Dp FIRESPflWICLEH5RE0D 6ASEMENT � <br /> �757 Sf t �/ MECHANICAL ' <br /> S A2 N 0 ❑ YES FJ NO <br /> OCCUPANCY OAD FIPEALApMREOD MEI6HTLWITATqN AUDITION�LPUNCMECK <br /> A O � � — <br /> RE,�«, oniER /D� <br /> STATE BUILDING SURCHARGE i/! r;/1 <br /> � <br /> . MTAI(EBY f�:ANSAPP�°VEDBV CITYOFEVEREIT F'UBLICWORKS <br /> .J Iv LOCAL SALES �� <br /> o�re �Z 5+ q3 T1U(COOE IS 3105 �Tu. � ' <br /> 7., ;.`� <br />