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r� <br /> 3fl s I c--� � o / r�-[�c2 .��� <br /> d1PP�ICATION FOR COIdSTRUCTIOI� PERMIT <br /> CITY OF EVERETf• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259-8810 <br /> ❑ DEMOLITION Cl COMDINATION ,� BUILDING i-cl MECHANICAL kl PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> s�33 �o�`' Dr. �,.1. , F�e,-e-f� <br /> OWNER M�ILAD��E55 CIiY ZIP PIIONE <br /> aai t- Wr,,,A T ]2811 Bth Ave N �A-201 Fverett, FIA 96204 2,Q.fi/57 3 006 <br /> ' TENANT ~ MAIL��OfiE55 Cltt ZIP PHONE <br /> AfiCHITECTORDES�GNE{7 MAILp0�flE55 CITY 21P PHONE <br /> GENEP�ICONTRACiOR N�'�.6UOf1ESS Citt ZIP PNONE STATELICENSE� <br /> $elect Homes,�nc_ 12811 A h AvP. W. #A�OI Ev ra p1A 98 04 206/573-9006 RFiF.l7P711nKN <br /> MECNANICALCONiRAC70R MMLA�D{iE55 CITY ZIP PIIONE STATELICENSEI <br /> IPLUMBINOCOMRRCTOR M�ILAODRESS Cltt 21P PNONE SiATEIICENSE� <br /> I CONTRACiPRICEOFWORK <br /> HEATING SYSTEM: DQ GAS ❑ ELECTRIC ❑ <br /> D SCRI E VJORK AND SOUARE FOOT�GE INVOLVEO CONiACT PERSON qN0 PHOIIE NO. <br /> Construction of one sinale fami� re 'd nce Randy Clark 206/513-9006 <br /> Beverly King 206/513-9006 <br /> I HEREBY CERTIFY THAT � HAVE READ AND EXAMINED THIS <br /> PROPOSEDUSE OF BUILDINO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNIYG THIS TYPE OF <br /> Sinqle familv dwellinq WORK WILL BE COMPIIED WITFi WHETHEF SPECIFIED HEREIN OR <br /> � LE�ALOESCRIPTfONOFPPOPERtt(SHOYMBELOWORATfACHTWOCOPIES� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tor 27 eiocK oF AUTHORITY TO '�ALATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> Merrill Greek Gardens D1V, 1 PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAFCELTA%I.D.NUMBER CONTRACTORS LAW 19.27 RCW AND 296.200 WAC. <br /> Sele Hanes /Inc. q <br /> CONSTPIICPONLO�NLENUER,AODRESS.TELEPHONENUMBER XBY• ' �< • � S'ZZ" /� <br /> /�(onP S�GNAtURE OA7E <br /> CItY BUSINESS LICENSE N0. <br /> PLUM6ING MF.CHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEF. NO. TYPE OF FIXTURE OR ITEM FEE <br /> 3 WATERCLOSET�TOILET) � A/C—AMNDLGUNITS—H.P. � <br /> I. BATHTUB ; 1 FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> 3 LAVATORY(WASH BASIN) � HEAT PUMP � <br /> 1 SHOWER � UNITNE�TERS—B.T.U. M ' <br /> 1 KITCHEN SINK 8 DISP i 1 CLOTHES DRYERS � <br /> 1 DISHWASHER � .� VENTILATION FAN � <br /> LAUNDRY TRAY i 1 RANGE HOOD i <br /> 1 CLOTHES WASHER � WATER HEATER � <br /> �-- <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD�URNING) i <br /> FLOOR DRAIN � PIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS i GAS FIREPLACE i <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE � <br /> ' GAS PIPING ' <br /> i EXHAUST FAIJ � <br /> � i <br /> i ' <br /> i � <br /> � � <br /> SUB TOTAL $ � SUB TOTAL $ �� <br /> P[RMIT $ i PERMIT $ y � <br /> TOTALFEE $ � TOTALFEE $ ' <br /> FOR OFFICE V`�E ONLY: <br /> FRONT SETBACK REAR SETB�CN SID@ SLTOr1CK PLAN CHECK MOER FEE �ECEIPT NO. .� <br /> � �s, i 20, S" �/v(a '�� �i� 7�/ <br /> usEzor+E �oranc� �c� VACAHTSITE FEES VALUATION FEE <br /> "� L _ /C� 7 .crrEs ❑ No euaoiNa G7 � )��� <br /> HEIGHTLIMITATION � NO.OFDWELLIN� SREOFBLDO/�i. � <br /> �l�Q UNI75 � ��j S� I.IVIAI�a� p�UM01NG 7 7� <br /> ��L� 46Z S CiR 4G <br /> OCCUPANCV NOAFSIOf11ES OCGUPANfLOAO BASENENT MECIIANIC�L .�� <br /> GROUP <br /> _3 � ❑YES NO I <br /> FIREALARMREO'D REASON AODI710HALPLANCIIECK � <br /> � OTNER <br /> FIRE SPPINNLER IlEO'0 fiE�50N <br /> �� STATE BUILDINO SURCIIMGE / � <br /> 7YPEDFCONST PlANSAPA(iO,VEQOY CITYOFEVERETT PU�IICYlORKS � i <br /> \J'� TAX COUE SL3 05 70TAL I <br /> .�L.-rJ o�tE s z5 9S <br />