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''�� ' ' ApPLICATI^N FOR CONSTRUC'�ON PERMITG <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT `^��r <br /> BASIC: HOL (City No. ZU� ) <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS p ELECTRIC p s I <br /> 259•8810 <br /> I DEw10UTION IgIxCOMBINATION I"I BUILDINC I I MECHANICAL I �pLUM81NG t i SIGN <br /> uWNER MML�DUN4.SS CITY ZIP PHONB -__-__' '-'___-"_ _. _. . <br /> SF.i.RCT HOMFG. INC 237 ELM ST EVERETT WA 98203 258 1503 <br /> iENANT M�ILADDRE55 GTY 21P --- <br /> Pl10NE <br /> MICHIfkCtOqDESRaNFiI AUILAUDRESS CIIY 21P PHOHE ---- _--' - <br /> GENEML CONTPI1C70R MAII ADDRE55 CITY ZIP P110NE SUit LICENS[I <br /> SELECT HOMES INC 237 F M ST_ EVERF.TT, WA 98203 258-1503 SELECHI110KN <br /> IAfCNMlIC�I IXNIIH�CI(NI M�N Ap[IR155 CITY 21P Y1qNL _�— •:INI �n.l N'A� -�--- � "� <br /> !•LUMBWGCONIR�C70H MAILADDflE55 CIIY 21P PMONE "�' """ SI�IkLIGLN5E1 .. . <br /> GONTP11C7 YO�LC OF WonK —""-- - <br /> 40000 <br /> I�ESCflIBE VIq11N AND}W�NF:f(JUTAGE iNVOIVf D CONT/iCT PEHSON NIO P11p/E NO -. . . <br /> ;� 339-0555 — —_-- _ <br /> �;^,� f • �§— 258-1503 <br /> 1 HEREBV CCflTIFY THAT I HAVE READ AND ExAMINED THIS <br /> NROPOSEo usE oF Bunr,,,,;, APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT AU. <br /> _SFR � PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> , i1�G�l0E5CqiPIKJNOFYNOPLHTv�S110WNBElOWOflATTALNTWOCOPIES) WpRK WILI 9E COMPLETED WITH WHETHER SPECIFIED HEREM OH <br /> Q, Hanabrook D1V �{ NOT. THF IIANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior—...�/— mocn pF _ <br /> AUTHOR TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTMER ST:.fE OR LOCAL UW REGULATING CONSTRUCTION OR TH[ <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWNER OF TMIS PROPER�fV TO PERFORM THE WORK FOR WHICH <br /> PARGELT�XIO.NUMBEH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONiRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> Select Homes, INc. <br /> CONS7flUGTqN LO�N LGNDCH,�ODBESS.TELEPNONC NUMBER <br /> '«- ------ Yhv• �p�,r <br /> PROJECT ADDHESS � �� �--�"'�`��- ����� i-y-9 y <br /> 5 � S CIIYWSNF$lClMSE1Q -- . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlIITURE OR ITEM FEE Np, TtlpE OF EOUIPMENT FEE <br /> �, WATEfl CLOSET(TOILET)_ � NC—ARiNOLG UNITS—H.P. <br /> � BATHTUB ' FORCEDAIRSYSTEMS—B.T.U. M E.A <br /> LAVATORY WASH BASIN --;--- <br /> �. ( 1 � UNIT HEATERS—B.LU. M <br /> � SHOWER � �� CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP � ; VENTILATION FAN � - <br /> DISHWASHER � RANGE HOOD -'� <br /> LAUNDRV TRAY � -�-�- �- �-- --�- � � <br /> � WATER MEATER <br /> '- -'— --- � . <br /> CLOTHES WASHER -- � ----� -- �-- -- <br /> � � WOOD S70VE <br /> URINAL � METAL FIREPLACE(WOOD BURNING) ' � <br /> DRINKING FOUNTAIN 3�'---- <br /> � FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � - � - �� <br /> BACKFLOW pREVENTERS ; GAS PIPING - � � � <br /> ROOF DRAINS—RAINLEADERS � �j EXHAUST FAN <br /> `INK(SERVICE—BAR,ETC.) � -- <br /> , — <br /> � <br /> • � <br /> � — <br /> � <br /> _ SUB TOTAL S ; SUB TOTAL E <br /> PERMIT s � PERMIT $ �� <br /> TOTALFEE f ' TOTALFEE S —�-- <br /> FOR OFfICE USE ONLY: <br /> I-NON7 SE70ACIt qE�R SFTBACN SIDE$ETO�CI( - <br /> I PWlCHECKNUMBER FEE 11[CflPl <br /> 'Lo � 20 � 'g. ar ! ��/-�� 3D �'�c� <br /> usi zex�e io��/i�vu vncnni srte FEES VALUATION FEE <br /> �r� �/C'1/� C� YES ❑ NO g�ILDING / /J1 �,l <br /> IYPEOfC-0r1T1S1 NOOFS70Ri[S occw�xtr n0lDnuwcul�tt � 1���_ __�7 �,/V <br /> J/,' 7U � 3 f PLUM&NG /n�� <br /> S�EOF�UC+ flq[SPfliN10.Eq5PE0'U BASEMENT ' <br /> 1 50 Sf + ___�(L ❑ YES �p MECHMIICAL L�/� , <br /> ��l <br /> UCCUPANCYIOeU hnrtM.pr�M�¢ou MNGH�lIM1TATqN ADDITIONALPLANCHECK <br /> A NJ 2"s � OiHER -- //V ; <br /> ucesON __L�! <br /> STATE BUILDING SURCHARGE ���) <br /> �N�NCEf1Y PLANSAPPUVEDOY CITYOFEVERETT pUBLICWOfiKS <br /> �I�' LOCAL SALES <br /> ���,E S g . TA)(CODE IS 31D5 TOTAL �n,i];C�!/ <br /> �y <br />