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j � APPLIC3�.TION FOR �CONSTR�CTION <br /> i . PERIIAIT <br /> ' Ihe Ereryieen � <br /> GTY OF <br /> PVPu�� <br /> everett � <br /> 1 BUILDING DEPARTMENT <br /> 25s•eeto TO BE COMPLE7ED IN INK— PLEASE PRINT <br /> • i <br /> OWNER M�4�DDPE55 GIiY ZIP PRONE I <br /> � SELECT HOMES, INC. PO BOX 708 MUKILTEO, WA 96275 827-8196 � <br /> TEN�NT M�IL�ODRE55 �ItY zip PNpNE � . <br /> n/a <br /> � �RCNREGTOROE910NER M�IL�O�N239 CRY zIV PNONE <br /> i <br /> n/a ' <br /> OENEN�LCONTP�CTOB M�IL�UORES9 CITY I�p PMONE �ICENSf � <br /> SELECT FiOM�S, INC. PO BOX 708 MUKILTEO, WA 98275 627-8196SELECHI11pKlJ y <br /> MECN�NICIILCON/R�CtON M11L��ORE39 CIiY IIP 1`NONE UGENSf� ����e <br /> ( <br /> J PLUMBINOGONiq�CTOR MML�DUqESS CIY z�n nNONE �If,ENF!' • <br /> � <br /> C�UX9lOiWOPN —��-- -- —.. . <br /> _ Cl-NEW ❑ ADDITION ❑ ALTERATION ❑ BBPAIq ❑ �EMOLITION ❑ W06�STOVE/FRP�INSER� ❑ BUILDINGRELOCATIDN <br /> tEN�NT IMPROVEMENf OR INiEHIOP qEMO�EI ONI� �ONT�Ct PERSON�Np 1'�IONE NO -'�� <br /> ' CONiR�CTPRICEOFWOPIb Randy Clark 348-1320/827-8196 <br /> i DE9CRIBEWORK11ND90U�REFOOUGEINVOlVEO Greg Stirn � <br /> cons ruction of sinql� familv residen e p"�sf� � /,�'O __ ', <br /> rnovoseou5eoreuaoiNo IHEREBVCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONi � <br /> 31l1 12 famil residence KNOWTHE9AMETOBETRUEANDCOiiRECT.ALLPROVI510NSOFlAW3P �. <br /> LEO�l0E5CRIPT14N OF PP'EPtVIS1.pWN BEIOW OP�iT�CN FOUR WPIE51 ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLETED N� <br /> . WHETMERSPECIFIEDHEREINORNOT.THEGFANTINGOFAPEFMITDOFS� <br /> � PRESUME TO piVE AUTHORIiY TO VIOLATE OR CANCEL THE PROVISION' <br /> �. LOT� BLocK oF . - ANYOTHERSTATEOf7LOCALLAWREGUTATINGCONSTHUCTIONORTHEi <br /> , FORMANCE OF CONSTqUC710N.TIiAT I AM AUTHORI2ED BY THE OWNF� <br /> . ��N A E HE DI . 1 THIS PROPERTYTO PERFORM iHE WORK FOR WHICH APPLICATION IS M <br /> AND 1 COMPLV WITH THE STATE CONTRACTORS LAW 18.27 RCW � <br /> , � 298200 WAC. <br /> . SIONRiUR OF NT 10NORAUT��ORIZEORGF.Ni O�iE <br /> Se t omes , Inc. <br /> X /—z �--90 <br /> , PROJECT�D�RE99 <br /> �r3a - �q7� pQ Sw . . LICAN L YPUSMESSLICENFENORNDPUSINESSNAME � <br /> ; PLUMBINO MECHANICAL J`� �� <br /> NO. TYPE OF FIXTURE OR ITEM FEE ' � NO. TYPE OF EOUIPMENT FEE <br /> , WATERCLOSET�TOILEn A/C—AIHNDLGUNITS—H.P. <br /> . BATHTUB 1 FORCED AIR SYSTEMS—B.i.U. M E0. <br /> � LAVATORV(WASH BASIN) UNIT HEATEFS—B.T.U. M <br /> ' SHOWER ], CLOTHESDRVERS <br /> �� KITCHEN SINKB DISP. 3 VENTILATION FAN <br /> i DISHWASHER ], RANGEHOOD <br /> I LAUNDRYTRAY j WATEq HEATER <br /> . CLOTHE9WA9HER WOODSTOVE <br /> � URINA� 1 METAL FIREPLACE 6 CHI�.iNEV 'jr) <br /> DRINKINO FOUNTAIN � FIREPLACEINSERT <br /> � FLOOR ORAIN ' HEAT PUMP � <br /> BACKFLOW PREVENTERS 1 GAS PIPING <br /> ROOFDRAINS—RAINLEAOERS � EXHAUSTFAN <br /> • SINK�SERVICE—BAR,ETC.� � • <br /> SUBTOTAL ! SUBTOTAL S � <br /> PERMIT S PERMIT 8 <br /> . TOTAL FEE S TOTAL FEE S <br /> ' FIIONTSETBRCN RERRSETB�CK SIOESETB/�CN � PUNCNECNNUMBEN FEE AECEIPfND. <br /> ?�� �� 6�d-/� ��1 p �- <br /> �. U9E20NE LOTAPE� WCANTSItE FEES YALUATIUN FEE <br /> ; �`/ �O. / S O NO <br /> �t BUILDING $6�1 5G�/ 5Q <br /> ' NPEOFfANST. OGCUP�NCYUROUP NOOFpWELLINOUNIT9 <br /> . euowse� i.cTua , .3 ' PLUMBINO �Q <br /> � BREOFBLDO, NOOF910PIE9 p9MT. OCGLO�O <br /> ; (q�, S� �N MECHANICAL ____ __ � <br /> NEIpNI LIM�T�IION OTHER ' <br /> � FIqEBPAINN�ER9RE0UIPED O YE9 Jj'NO �+� STATE BUILDING SURCHARGE �_ <br /> •� � � . 9TATE ENEROV SURCHAROE <br /> ' �VPIIC�TION�CG BY PUN9�PPR.BY <br /> S mrn. - -_. __ P�a���WOAKs - 0 <br /> TOTAL � <br /> .�f"'... .� .... .. -. , . . ., .. . . .. .. . ...�.......r ) "'...wv...�......... ._ . ... . . _ ..� <br />