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�. <br />�� <br />APPLICATION FOR CONSTRUCTION PERMIT <br />ev��ret[ <br />iheEveryreen IIASIC: COTTONWOOD � <br />CITY OF <br />everett . . <br />BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br />259-BB10 <br />DEMOLITION I i COMBINATION ❑ BUILDING ❑ MECHANICAL I 1 PLUMBING i � SIGN <br />UWNER 1MILADORE55 CITY ZW P110NE <br />SEL�CT HOMES, INC. 237 EI,M STREBT, EVERETT, WA 98203 206 258-1503 <br />II.nANT M�III�DORE55 GTY ZIP P110NE <br />nNCHITEGTOliDESM.NER lULLA0DNE55 ��n Z�P P�E <br />GENEMLCONiMCIOH MAILADDRE55 LIiY ZIP ��ONE IICENS[� <br />SELECT HOPIES, INC. 237 ELM STREBT, EVERETT, WA 98203 206-258-1503 SELECIII110KN <br />MICNNIiGLLCONilUC1011 MML��DNE55 GITY 21P PNONE IICINA• <br />�pN7qALTpp MA0. AODPEES <br />cm <br />cuss oF woan <br />:XXNEW I l ADDITION I I ALTERATION f 1 REPAIR ❑ <br />ICN�NT W VNOVEMEN� OR MtEHIOR HEMOOEI ONLY <br />Cd111UCT PPICE OF WJRK: �� ��� _ <br />11E$LqIBE WIXiK ANU SOUAflF. FOOTAGE INVOIVED <br />CONSTRUCTION OF SINGLE FAMILY RESIDEN <br />SINGLE FAMILY RESIDENCE <br />�[G/iL OESCRIPTION OF FflOF.ERtt �SHOWN BEI OW 011 ATfACH FW fl COPIES) <br />�OT_� BLOLK � <br />�� <br />�U'L.5-�{r�� / <br />BING <br />TYPE OF FIKTI <br />WATER CIOSET (TOILI <br />BATHTUB <br />LAVATORV�WASH BA: <br />SHOWER <br />KITCNEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHFS WASHER <br />URINAL <br />DRINKING FOUNTA�N <br />FLOOR ORAIN <br />BACKFLOW PREVENT <br />ROOF DRAINS—RAINI <br />SINK ISERVICE—BAR <br />111(NIISLIBACN/ NLNISLItlACN ' <br />usk 20NE_ l0T MEA �J <br />` <br />'���I 01 ��'N51 MIOWI�tlII IYI'( p CON51. ACION <br />—r—P <br />NO.OF SiOfiiES <br />f iHE SPHHnL@I15 �N�k00 <br />I I YES l�!NO <br />��LASON FOR SPRINHlEflS <br />nPPLIC�iIONACC BV � PLRNS <br />93 <br />SWE 5EIBAC.�/ <br />� <br />VIIONE IICENSE 1 <br />DEMOI.ITION ❑ WOODSTOVE/FRPL INSERT l7 BUILDING RELOCATICN! <br />CONf/CT PEPSON MID PlldlE Iq. <br />RANDY CLARK 258-1503 <br />wcrN ite <br />YES ❑ NO <br />acwucr woao+curoi <br />BASEMENT �� <br />I I VES (Kk0 <br />NEIGHT IIMITl1Tl� <br />7� <br />CSTY OF EVEREfT <br />LOCALSALES <br />TAX CODE IS 3105 <br />GARY KLICK 339-0555 <br />1 HEREBY CEflTIFY TMAT I HAVE READ AND EXAMINED THIS <br />APPUCATION ANQ KNOW THE SAME 70 BE TRUt AND CORRECT. Al;. <br />PflOVISIONS OF U1VS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE CM�IPLETED WITH WMETMER SPECIFIEO HEREIN OR <br />NOT. THE GRR'• �.*IG OF A PERMIT DOES NOT PRESUME TG GIVE <br />AUTHORITV 1. IOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE l�� � LOCAL LAW REGULATING CONSTRUCTION OH THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS W 1827 RCW AND 2962D0 WAC. <br />$1('1UTUREOF TOIi �UTMORIZE��GEN7 O�TE <br />'SELEC'� OME�, INC. <br />X <br />r <br />8 CHIMNEV <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />OTHER (,{�r�y`_ _ <br />�J <br />ST�TE BUILD�NG SURCHARGE <br />STATEENERGYSURCMAPGE <br />PUBLIC WORNS <br />TOTAL <br />FEt <br />M <br />S T- <br />NLLF�pI NO �_� <br />�/ <br />FEE <br />��_ <br />�� i OV <br />__LVy <br />l� ' (lL <br />� <br />,�0 � <br />� <br />