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,_� _. <br /> APPLICATII.�V FOR CONSTRUCI .ON PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION ❑ CQMBINATION ❑ BUILDING ❑ MECHANICAL Cl PLUMBING (� SIGN <br /> PROJECT ADDRESS n <br /> J��v3,�1 /� � /�h C� Lc�-� �Lo <br /> OWNEA MNL�DUIlESS CITY ZIP �HONE <br /> Select Homes 12811 Sth Ave W IIA-201 Gverett WA 98204 513-9006 <br /> 7GNANT Mm�noonr:ss cnv zia ri�o��e <br /> ARCHITECTOi7f1E51Gk..R MARA�OFiESS GRV ]IP PHONE <br /> GENFRAICONTFl4CTOR MAI��pORESS CIiV ]IP PIIONG $iATELICEN$Ex <br /> MELHANICALCONTRACTOR MAILA�ORESS CITV ZIP PHONE STATELICENSE+ <br /> Anchor PlumbinQ PO Box 1478 Marysville 98270 286-7889 ANCHORPH141LN <br /> PLUMBINGCONTRACTOR MAILA�ORESS Cltt ZIP PHONE STFTELICENSEx <br /> CONiPFCT PRICE OF WORK <br /> HEATING SYSTEM: ❑ GAS ❑ ELEC'i RIC f_7 <br /> DESCRIDE WOHK ANO SOU�RE FOOTAGE INVOIVED GONT�CT PERSON�NU PHONC-N0. <br /> Sprinkler �(J � <br /> � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Faovoseo use oF euaoiNo ' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> SFR WORK WILL BE COMPIIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL�ESCRIPTIONOFPROPEflTY�SHOWNBELOWORATfACHTVOCOPIES� NOT. THE GRANTING DF A PERMIT DOES NOT PRESUME TO GIVE <br /> , ior e�och or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCCLTA%I.D.Nl1MBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> / <br /> CONSTRl1CTION LOAN LEN�ER,ADDRESS.TELEPNONE NUM�ER X .s��j/'�S <br /> SIGN�TURE DATE <br /> CITV�OSINE55 UGENSE NO. <br /> PLUMBING MECHANICAI <br /> N0. TYPE OF FIXTUAE UR ITEM FEE NO. TYPE OF F:XTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) i A/C—A/HNDLG UNITS—H.P. � <br /> ' BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNITHEATERS—B.T.U. M � <br /> KITCHEN SINK 8 DISP � CLOTHES DRYERS i <br /> DISHWASHER � VENTILATION FAN <br /> LAUNDRY TRAY ; RANGE HOOD ; � <br /> CLOTHES WASHER � WATER NEATER <br /> URINAL � WOOD STOVE ' <br /> DRINKING FOUNTAIN ; METAL FIREPLACE(WOOD BURNING) � <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> 84CKFLOW PREVENTERS ; GASFIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) GAS fiANGE <br /> ; GAS PIPING ; <br /> � EXHAUSTFAN � <br /> i � <br /> � � <br /> SUB TOTAL S ; SUB TOTAL S ! <br /> PERMIT S PERMIT S i <br /> � TOTA�FEE S ' TOTALFEE 5 � <br /> FOR OFFICE USE ONLY: <br /> FqONTSET�ACK R[PRSETOACK SIDESETBACK PLANC�{ECKNU\t R FEE �ECEIPTNO. <br /> � ��J � �� <br /> lJ <br /> USEZONE LOTFFLA V�LFNTSITE FEES VAIUATION FEE <br /> ❑YES ❑ �0 pWL01NG � <br /> i <br /> HEIGIIT LIMIT.ITIOY NO OF DYIELLING SIZE OF�LOGRI. � <br /> UNITS p��iN01NG � <br /> ' <br /> OLCUPANCY NOAFSTOFIES OCCUPANTLOAO BASEMENT MECHA4ICAL � <br /> GROUP <br /> ❑YES f7 NO i <br /> FIRE ALARM REO'D REPSON AODITIONAL PIAN CHECK � <br /> i <br /> OTHER �I��/�J �� i� <br /> FIRESPRINKLERREO'0 REASON - � <br /> i <br /> STATE BU OING SURCHARGE i <br /> TYPEOFCONSi PLANS P�EDBV CITYOFEVERETT PU�tICWORNS � <br /> LOCALSALES <br /> oAT �5� TAX CODE IS 3105 TOTAL I <br /> — — � <br />