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� � APPLI�:,ATION FOR CONSTIRc�LCT1ON <br /> PERMIT <br /> flre Everproen <br /> GTV OF twrrptl <br /> everett e <br /> BUILDING DEPARTMENi <br /> 259•98t0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MRILPDORE55 GIiV j�P P��ONE <br /> SELECT HOMES, INC. PO BOX 708 MUKILTEO, WA 98275 827-8196 <br /> iENANT MRILAOORESS CIiY 21P PHONE <br /> • n/a <br /> �RCNITECTORDESIONER MAII.qODRE55 CIIY TIP pHONE <br /> n/a <br /> UENER�LCONTRRCiON MAILADpRE55 CITY 21a PIIONE LIGENSE� <br /> SELECT HOME�, TNC. PO DOX 708 MUKILTEO, WA 98275 827-8196SELECHI110FCP: <br /> MECH�NICALCONiR�CTOR MnILA�ONE55 CIIY 21P P��ONE LILENSE• <br /> PLUM9INOCONiR.1CTOR NMI�DURESS CIfY 211` PIIONC LIf,FNSf• <br /> CL�7��,SSOFVAPN - ------"------'---" <br /> C]XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRP�INSERT ❑ AUILDINC�RELOC/1TION i <br /> 1EN�NTIMVROVEMENiOAINiE�IORPEM00[LONLV CONT�CTPEPSONAND�NpN[NO �� � � . <br /> CONTF�CT1'RICEOFWORK Randy Clark 348-1320/627-8196 '�, <br /> pESGNIBEWORR�NOSOWIREFOOT�481NVOLVEO � � I <br /> Greg Stirn--8�--�t�`i �S��ISO� , <br /> con;,truction of sirgle family residen e <br /> VROPo9EOUSEOFBUI�DINO IHEPEBVC[RTIFVTHATIHAVEREADANDEXAMINE�THISAPPLICATIONAND � <br /> single famil residence HNOWTHES.4METOBEiFUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> ieoe�oescmm�oNorrrorenrv�s�owNaeiowon�necHrouncoriesi C(7Q1�:�NCESGOVERNINGTHIS7VPEOFWORKWILLBECOMPLETEDWITI-I <br /> WHETHEFSFECIFIEDHEFi�INORNOT.THEGRANiINGOFAPERMIi DOESNUt <br /> PRESUME TO(iIVE AU7f10�7�TV 70 VIOLATE OR CANCEL THE PROVISIONS OF <br /> loi BIOCK_ ov ANYOTHERSTATEORLOCALLAWREGUTATINGCONSTRUCTIONORTHEPER� <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> C�I.ENHAuEN NElGNTS �IIJZ THISPROPER7YTOPERFORMTHEWORKFORWHICHAPPLICATIONISMADE <br /> AND I COMPLV WITFI iHE S7ATE CONiRACTORS LAW IB27 RCW AND <br /> 29620U W.qC. <br /> 910NMUfiF�OF�pNIRp pt10���Ut�IOPIZEDI.GENt ONtE <br /> Se�ec E mes, Inc. ��L���D <br /> X <br /> PH�JJEGtAD�RE55 <br /> 0 3 . L/��� �� �� . 1 1�1Ni5 li 5 StIf,ENSENOPNOBUSINESSNAME . <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FIXTUHE OR ITEM FEE NO. TYPE OF EOUIPMENT ••� FEE <br /> WATERCL03F_TIiOI.En — /VC—PJHNDLGUNITS—H.P. �� <br /> 2 BATHTUB :!� ' 1 FORCED AIR SYSTEMS—B.T.U. M E0. � <br /> _ '�- LAVATOFY(WASHBASIN) — UNITHEATERS—B.T.U. M <br /> SHOWEH ' — 1 CLOTHESC9VER5 � <br /> KITCHEN SINK d DISP. — 3 VENTILA710N FAN <br /> DISHWASHER "' ]. RANGEHOOD � '� <br /> LAUNDHVTAAV 1 WATERHEATER <br /> CLOtHES WASHER WOOD STOVE � <br /> UHIfJAL f 1 METAL FIREPLACE 8 LHIMNEY___ �9 ^ � <br /> ORINKINO FOUNTAIN FIREPLACEINSERT <br /> _—_— _ _—_.'_.._—.__.—_ __. . ._ .._.._ _ .. . <br /> FLOOP DfiAIN ' HEAT PUMP ' <br /> BACKFLOW PREVENTERS ], GAS PIPING ' <br /> ROOF DRAINS—FAINLEADERS EXHAUST FAk <br /> SI NK(SERVICE—BAR,ETC.) � <br /> SUBTOiAL S G � SUBTOTAL 3 0 — � <br /> � PERMIT S PERMIT 5 <br /> TOTP.L FEE 5 Go � 10TAL FEE 5 �' <br /> �PONISEiB�CN R6iR5EiE�CR SIpESETBRGN PUNCHELKNUM9ER FEE AELEIPfNO. <br /> �� 2D � 6 � y'o / a a �y7 � s�. 3 � /7 a <br /> useior+e totaqee V/.CpNiSITE FEES VALUATION FEE <br /> cT J�FES ❑ NO <br /> �� ) 7 J— BUILDING foy ' S� <br /> TYPEOFCANST. IX:CUP�HCVGROUP NO.OFOWELlIHOUNITS / - <br /> euow�eieiecrue� PLUMBING �p o <br /> E12E O�6LD(3 NO C`S�UNIES &4MT. OCC LO�D _� <br /> � n r MECHANICAL 90 _ <br /> IIEIONILIMIIAtION OTHER <br /> '7� / <br /> FIqE 9PRINKLENSREOl11RcD ❑YES CI NO LLJ , STATE BUILO�NG SUF7CHARGE y S�� <br /> STATF ENERGV SUACHqqGE � <br /> �VVUGAtION�CC.BY PL�N9�PPR6Y <br /> I PUBLIC WORKS � <br /> TOTAL �� � <br />