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�, �jarur�� �G I (�-�s.�, �{ ,Qe-'�Q �`i <br />� AP�`►L�CA710N FQ��i CONSTRUCTiOW PERNi1T <br />� CITY OF �V�RETT• BUILUING DIVISION <br /> 3200 CFDAR STfiCc T• EVERETT, WA 98201 • 259-8810 <br /> fl DEMOLITION f�l COMBINATION fit BU!LDING kl MECHANICAL fcl PLUMBING I 1 SIGN <br /> i PROJEC7 pDDRESS <br /> S�/O /D � /.�Q. N�. c✓EaeN Wp . 582-a3 <br /> ow�+en rnni�nouness cirv zir rnor+e <br />� Ralr��t urnv�c Tnr 1�^.gll 8th Ave_ i�' #A-'l01 EvQ�g� F1A 98204 20(�51_3-900[ <br /> ter+nNr �nniinoonrss cnv zir rnor+e - <br /> I ARCIIITECTORDESIGNER MAILACPPE55 CIIV Z,P PNONF <br />� GENEfULCONiMCTOfI Mp11.A0��E55 CIiV ZIP PIIONE STATELICEN£EN <br /> Select Hq��, Tn� 1�R11 g h AV .. W. #A— Ol � r 7'et � PIA 98204 20F/Sl'�-900Fi RF.T�F.CTT11(1T(AT <br /> MECHANICALCON7R�C10R MAILADOf1E5S CITV 71P PIIONE STATELICENSE� <br /> PLUMBINGCONTRACTOR MAILAO�RE55 CITY 21P PIIONE STATELICENSEM <br /> CONiRACT PRICE OF Y/OI1K <br /> 9.99--= <br /> HEAI'ING SYSTEM: .�GAS ❑ ELECTRIC ❑ <br /> 0 SCqI EWORKANOSOI'�HEF00T4GEINVOLVEO CONThCiPER50NANDP110NEN0. <br /> Construction of one sina� = amil esidence d Clark 206 513- <br /> Beverly King 206/513-9006 <br /> I HEREBY CERTIFY THAT I HAVE READ APlD EXAMINED THIS <br /> 1'ROPOSED USE OF BUIL�ING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> Sli1q12 f3m.'LlV dwelliilq PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK '�VILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN 09 <br /> LEGALDESCRIPTIONOfPROPEFTV�SHOWNBELOWOPA7TACH7YlOCOPIES) NOT. THE GRANTING OF A PERMIT DOES �OT PRESUME TO GIVE <br /> �ot /'''� e�ocK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> Mes�-i11 Creek Gardens D1V. 1 PEFFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFIZED BY THE <br /> OWNE� OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CUMPLY WITH THE STATE <br /> PARCELT�XLD.NUMBER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> Select Hanes, Inc. <br /> CONSTRUCTIONLOANLENDER,AO�RESS,TELEPHONENUMBER XBy• �,vy�,� �N� ,,;'Z�'i5- <br /> SIGNATURE OAIE <br /> CITV AUSINE'_S IICENSE N0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI7CTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> 3 WATER CLOSET(TOILET) � A/C—AMNDLG UNITS—H.P. � <br /> 1 BATHTUB ; 1 FORCED Alfi SY£TEMS—B.LU. M E.A. ; � <br /> 3 LAVATOE"(WASH BASIN) � HEAT PUMP , I <br /> 1 SHOWEFl � UNITHEATERS—B.T.U. M � <br /> l. KITCHEN SINK 8 DISP � 1 CLOTHES ORYERS � <br /> 1 DISHWASHER � � VENTILATION FAN �— <br /> LAUNDRY TRAY ; 1 RANGE HOOD ; <br /> 1 CLOTHES WASHER i 1 �yATER HEATER i <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN � MET�L FIREPLACE(WOOD PURNING) � <br /> FLOOR DRAIN � FIfiEP�ACE INSFRT(WOOD BURNING) � <br /> BACKFLOW PREVEtJTERS � GAS FIREPLACE ' <br /> � <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> � 3'eg• GAS PIPING ' <br /> i EXHAUSTfAN i <br /> � � <br /> i i <br /> i <br /> � � <br /> SUB TOTAL $ � SUO TOTAL S ; <br /> PERMIT 3 � PERMIT 5 � <br /> TO'!AL FEE $ � TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> FRONT,SET�CN j RE�f1SET��� SI�ESEiB� PLANC�E NNUA�OEij FE�E_� — fiECEI�NO./ / � <br /> G �r Z <br /> usEzoNe �ornnea��y� vncnrvtsire FEES VALUATION PEE <br /> / nv�s ❑ uo pUIIDING ^Z g-�3 ,�� �� — <br /> HEIGHi LIMIT il NO GF DWEILING S¢E Of�LDGRI. �— <br /> � l ur+its 21y.7 Sf- Li1/intc,.t riun+oiNc _� _� I <br /> l Sr- - �7iCAc.� <br /> OCCUPANCY NOAFSi0PIE5 OCCUPAbILOA� 9115EMENT MECII�NICAL C1 � <br /> GRO P � <br /> .3 �� ' nres WF�+o <br /> FlREALARM{iE0'D REASON PDDITIONALPLANCHGCH -_J_. <br /> � � �� i <br /> J OTHER ' . � i <br /> �_ <br /> FIRE SPpINK ER REO'D REASON - � <br /> 'L �� � STAIEOUILDINGSUfiG11MGE � �j�%,' <br /> CSc�.- �1L- <br /> TY O CONST.% PV�NSAPPPOVED9Y �J/'I i <br /> ��,.- . �� CITYOPEVERETT ruoucwonKs _ .__� ,_ <br /> LOCAL SALES <br /> �/� D�TE 3 2� ;. - TAX CODE IS 3105 TOTAL � i!� <br /> � <br />