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:� + ' <br /> �_ �•��.. ,. <br /> i, � APPLIC��ION FOR CONSTR4�TIdN <br /> 1 PERMIT <br /> ' fhs Erer9reen . <br /> � CITYOF <br /> rvru�l l <br /> � everett e <br /> i B'JILDING DEPARTMENT <br /> �) 259•BB10 TO BE COMPLETED IN INK— PLEASE PRINT <br /> � <br /> ..� OWNER M�II�DDPE55 GTY . ZIP V��OHE ' <br /> ,� SELECT HOMES, INC. PO BOX 708 MUKILTEO� 'WA 98275 627-8196 � <br /> IENANT M��L�DDRE55 CITY IIP PHONF <br /> `3 ' n�a �I <br /> �i1GMREGTORDE910Nf.f1 M�ILAO�RE99 Cilv --' � ' <br /> +i Iu� P��ONf: _'_"____""" , <br /> i' n/a <br /> �'� OENER�LCONTR�CTOR M�ILAO�HE55 CIIv ZIP PHON[ LICEHSE� <br /> ! SELECT HOM�S, INC. PO IIOX 708 MUKILTEO, WA 9E275 827-8196SELEQiI110Kf: ';� <br /> � MECM�NIC�LLONTR�CIOR M�ILAOORE55 CITV LP PUONE LIGENSE• I <br /> 'i <br /> VLUMBINOGONIR�CIOR MAILAOORESS CItV zIP PHONE �ICENSEr <br /> 1 <br /> .r C�LAXSSOFN9FN _ <br /> LT-NEW ❑ AOOIT�ON ❑ ALTERATION ❑ REPAIR ❑ �EMOLITION ❑ WOODSTUVE/FRPi. INiERi ❑ Bl11lDING REIOCATION <br /> 1 TEN�NTIMVROVEMENTORINfERIOHREMOOEIONLY fANTACTPEPSONANDPMONfNO . <br /> � CONTRIICTPRICEOPWORK Randy C1aYk 348-1320/824-9346- <br /> �� UESCRIBEWONNANDSOUAPEFOOTAOEIN\'JLVFD Greg t rIl <br /> � con�truction of sin le famil residen e a,���SCL� <br /> .� PROP09EDUSEOFBUIl01N0 <br /> I HEREBV CERTIFY TFIAi I HAVE READ AND E%AMINED THIS APPLICATION AN D <br /> sinale familv residence KNOW?HESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFIAWSANO <br /> LEOAL OESCRIPTION OF PROPERfY�SHOWN BELOW OR�TTRCH iOUH COPIESI ORDINhNCES GOVERNING THIS NPE OF WOFK WILL BE COMPLETED W ITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRAN7ING OF A PERMIT DOES NOT <br /> ' lor� BLocN or PfiESUME TO GIVE AUTHORIN TO VIOLATE OA CANCEI THE PROVISIONS OF <br /> ' ANV OTHER SiATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE PER� <br /> I FORMANCE OF CONSTRUCTION.THAT 1 AM AU7HORI2ED BV THE OWNER OF <br /> ��NEIAUEN NElvkrs II THISPROPEFNTOPFRFORMTHEWORKFORWHICHAPPLICATIONISMADE <br /> AND I COMPI.y WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296.200 WAC: <br /> � SIONII�UR Of�O FALIOROHRUIIIOFREDIGENI OAtE <br /> ' Se�e H �es, Inc. <br /> i <br /> ^ --- X —Zya �( <br /> � PAOJECi�DOOf.99 • ��//,..'_'_ _' <br /> V <br /> ' AUE � • � �CANT9 91N ,. Uf,ENSENJ AN BUSINESSNAME � -- " <br /> '1 <br /> ti PLUMBIN6 MECMANICAL . <br /> �i NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) /VC-IV IiNOLO UNITS-H.P. <br /> ;t BATHTUB 1 FOFCEDAIRSYSTEMS-FJ.T.U. MEA <br /> ..� LAVATORV(WASH BASIN) UNIT HEATERS-&T.U. M � <br /> ';� SNOWER — 1 CLOTHESDRYERS <br /> ;;� KITCHENSINKBDISP. 3 VENTILATIONFAN <br /> ,� <br /> �; DISHWASHER 1 RANQE HOOD , <br /> � LAUNORYTRAV 1 WATERHEATER - <br /> �..;� CIOTHESWASHER WOOOSTOVE '.. <br /> ;� URINA� 1 MF.TFL FIqEPLACE 8 CHIMNEV �, <br /> ,-� ORINKINO FOUNTAIN FIPEPLACEINSERT <br /> �t FLOOFDRAIN HEATPUMP <br /> ,� BACKFLOW PFEVENTERS ], GAS PIPING <br /> -'� ROOFDRAINS-RAINLEADERS EXHAUSTFAN � <br /> � SINK�SERVICE-BAR,ETC,) - <br /> ; <br /> j <br /> 1 <br /> S <br /> SUBTOTAL S SUBTOTAL S <br /> j ' PERMIT S PERMIT 5 <br /> � TOTAL FEE S TOTAL FEE S —^ <br /> n FRONTSEi9�'N pEARSETBACK SIpESETBRCN PUNGHECKNUMBEq FEE AECEIPfNO. <br /> � � � ' � ' B a3i d� �r�c <br /> � USEi LOT�REA v�ceNr9r FEES VALUATION FEE i <br /> ,� �1 �O/' }/4Es�o BUILDING 5�'"� <br /> J \ <br /> TYFEOFCONST. OCC4PANGYOqpUP NO.OFDWELLINUUNITS ��.:'� <br /> MLOWABLE/�GTWL �. — . <br /> PLUMBING <br /> 91ZEOFBLD(3. NO.OFSTORIES BSMi OCGLOAD —' <br /> ' � ❑r ��FCHAN�CAL �' <br /> .� <br /> � NEIGHTIIMIT��ON OTHER <br /> `� FIqE3PRINNLER5RE0UIFE0 ❑YES ❑NO � STATE BUILOING SURCHARGE <br /> " L <br /> �� STATE ENERGY SURGHARGE <br /> APPLIC�TIONACC6Y PL�N9�PVR.BY -- <br /> � PUBIIC WORKS � <br /> G TOTAL � �I �• <br /> � <br /> : ' <br /> d <br /> � <br /> ��:o•; •-.q' .�.. .T 51. ... .. ,_. ,,. . - _ <br /> , , . , ... ,. . .�...._ .. �. ..�.. . . ._ .. . . ... . <br /> 1' .:t, <br />