Laserfiche WebLink
1 <br />APPLICATI^N FOR CONSTRIUC'''ON PERMIT <br />• TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BASIC PLAN: MAPLE (CITY NO. 107 ) <br />BUILDING DEPARTMENT HEATINGSYSTEM: UFO UELECTRIC U _.--_.- <br />259-8810 <br />I DEMOLITION N COMBINATION ❑ BUILDING ❑ MECHANICAL I I PLUMBING I I SIGN <br />OwMN w&A lm aw zo PNaIE <br />SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 <br />ll~ WL AXPESS CPY zW P E — <br />ANCMIECIOPnsI . WLM ESS CITY }p MI f <br />GUAPNCX1WIC WL MK*IEss Clry Z, Pn L SIME ECLNYP <br />SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 SELECHI110KN <br />4EaVNCN CMIPACla1 wL EXn55 C." zW PHONE SIAIE t.tw. <br />'LWB CONIMTM Wk KXMEM cm zP MJNE SIAILLCENU. <br />40000 i w■ <br />scPnE flDlll AND SOUME EXIAGF W WLV[O CUNI/Li PfflSOH Mq PrgIE Iq <br />258-1503 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />PIIOPDUDI Ixwl P <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />IEWL MKRIPIq Q PPOPCwYI$IIOVr11 IKLO OP ALUCN 1NOCa'[51 <br />a 5 HANABROOK <br />DIV 3 <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />ml wXl a <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />�Q <br />OWNER OF THIS PROPERTY TO PERFORM THE WIRK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE. <br />C NTRA TO A 27 TWND 296200 WAC. <br />ELE T [ <br />I•AHCIL IAL I o mlum R <br />CONSIPXIM LOAN l[NOER. A➢ORC55, 1[ILINCHE Matl[P <br />5923 <br />uAruw wn <br />ar. ww <br />MECHANICAL4 M <br />PROJECT ADDRESS <br />PLUMBING <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. TYPE OF EQUIPMENT FEE <br />3 <br />WATER CLOSET (TOILET) <br />AlE-NHNDLG UNITS-H P <br />le I <br />BATHTUB <br />_ <br />I FOHCEOAIRSYSTEMS-BT.O M E.A. <br />3 <br />UVATORY(WASH BASIN) <br />'�_ <br />UNIT HEATERS-BJU. M <br />SHOWER <br />I CLOTHES DRYERS <br />I <br />KITCHEN SINK A DISP <br />VENTILAT.ON FAN <br />1 <br />DISHWASHER <br />1 RANGE HOOD —�— <br />LAUNDRY TRAY <br />1 WATER HEATER <br />1 <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL _ <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR GRAIN <br />iHEAT <br />PUMP <br />BACKFLOW PREVENTERS <br />'1,. GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />_ <br />EXHAUST FAN <br />SINK (SERVICE -BAR ETC) <br />SUB TOTAL <br />f <br />SUB TOTAL f/gyp <br />PERMIT <br />f <br />PERMIT f <br />TOTALFEE <br />f <br />TOTAL FEE f <br />FOR <br />OFFICE USE ONLY: <br />IPmisciPAcrL <br />nAR-Ll <br />soE S[IBACK <br />PU CKICMMR <br />I FEE <br />n0 <br />Y12 <br />Ilu mn <br />Lor APu <br />vAc�w/LT�vTE <br />FEES <br />I VALUATION <br />FEE <br />❑ No <br />BUILDING <br />Int ataal <br />NOuslDPls <br />®P.cl norwlLrrn <br />- <br />Z <br />u� <br />xL'YBWA <br />, <br />sVEan <br />EMK SPPxuENs nOD <br />' ``ES <br />I52Y 5f GA <br />O <br />LlYxT <br />❑ Ba'% <br />YEfAIArEICY <br />O' <br />=WA vLM <br />Lun uANYwoo <br />K"T1u11A101 <br />ADDIlKI1NL PLAII CHECK <br />STATE Ball SUACW4GE A IaNu^API•IpVXsr CITY OF EVERETT IC PUBLWORIcS <br />fd' LOCAL SALES <br />wlE S�y ACE �L73 TAT( CODE IS 3105 I TDTu _ 7,/ <br />