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APPLIC���TION FOR �ONSTRI�~��'!ON <br /> PERMIT <br /> the Evorg�een <br /> CITV OF <br /> rvrn•II <br /> �everett e <br /> BUILDING DEPARTMENT <br /> 2E9•8810 T:1 BE COMPLETED IN INY- PLEASE PRINT <br />� �JWNER MRIL��UI1C55 UIY ZIF PIIONE <br /> SGLECT HOMES, INC. PO BOX 708 MUKlLTEO, WA 98275 82i-8196 <br /> �ENANT M�ILAO�fiE55 (;'LY pIP PIIONE <br /> n/a <br />', �RCIIIiECT0�0E510N[R MAllp0�RE5S Clil' —IIP----- PIIpNC �— ' <br /> n/a <br /> OENERALLONRlRGIOfi MAIL�OOIlE55 CIIY IIP PIIONE LIGCNSE• <br /> SEL�CT IIOM�S, INC. PO IIOX 708 MUKILTGO, SdA 98275 827-B196 SELEQ�I110KC: <br /> MECN�NIC�LCONiPnC10R M�IL�DOf1E55 GIiV �Ip PHpN[ �ICENS[• <br /> PLUM6INOGONIMCtO� MMl���RESS CIIY pIP � PHONE ��f,[N9f• <br /> C�L,RXSS OF WOi1N — � <br /> LT-NEW ❑ A�DITION ❑ ALTE��f�r`Y ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVE/PFPI.INSERT ❑ 13UI�DING9ELOCATION <br /> 1EN�Ni iMPROVEMENi OR INIEHIOf11iEMO�EL VNLv CONinCi PF��SON ANp 1'��ON[NO �- <br /> cor+m�crrniceorwo: Randy Clark 398--1320/827-8196 <br /> OESGPIDEWOf1NnN�500enF.fOOIAGEwVOLVED Greg Stii'n --���-�-�-�i � <br /> construction of sinqle familv residen e ��SS'-- / �O�_ <br /> PROPoSEO USF.OF BWl01NG — — <br /> I HEREBV CERTIFV THAT I HAVE READ AND[XAMMED 7HI5 APPLICA710N AND <br /> sinqle familY re,sidence KNOW?HESAMETOBETRUEANDCORRECTALLPROVISIONSOfLAW5AN0 <br /> LE'�AI.pESCRtP1i0N OF PqOPERiV�SIIOW N PILOW OR p�IRCN fOUR GOPIE51 ORDINANCES GOVERNING Tf IIS TYPE OF WOR K W ILL BE COMPLETED VAThI <br /> WHETHEF SPECIFIED HEREIN OR NOT.THEGRANTINCOFAPERAIITDOES NO7 <br /> PRESUME TO�IVE AUTHORITV TO VIOLATE OR CANCEL 7HE PROVIS17NS OF <br /> toi_ A�ocK or __ ANYOtHERSTATEORLOCAILAWpEGULATINGCONSTRUCTIONORTHEPER� <br /> FG7MANCE OF COIJSTRUCTION.THAT I AM AUTHOqIZED BV THE OWI�ER OF <br /> ��-EN FIAIJE f�I HE�C��S THIS PHOPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADG <br /> AND I GOMPLY WITH THE SiATE CONTRACiORS LAW 1827 RCW AND <br /> 296200 WAC. <br /> SIONRTUf1 OfC ittAC �I1pRqU1HORIZEDAGENi UAtE <br /> Se1ec I mes, Inc. <br /> X <br /> -- -- - ---- -- 1y�!,Y Z <br /> 1`IIp.IL(:IAlllllll'l:i APPLI NI ❑ U511lC311f,1.N.^.fNU�NpppSM[SSNAIA�[ �.�� . . . <br /> So10 �L� f" PQ (,U <br /> PLUMBINO ECHpNICAL <br /> NO. TYPE OF FIXTURE OR I7EM FEE N�. TYPE OF EOUIPMENT FEE <br /> WA7ER CLOSET(TUiIEi) A/C—A/HNULG UNITS—H.P. <br /> Z BATHTUB ,L fOFCED AIR SYSTEMS—B.T.U. M EA <br /> LAVATORY�WASHPASIN) _� UNIThIEATERS—B.T.U. M <br /> SHOWER � ]. CLOTHES DRYERS <br /> KITCHEN SINK 8 UISP. 3 VENTILATION FAN <br /> D{SHWASHEF f ], RANGE HOOD <br /> LAUNDRYTqAY � 1 WATERFIEATER <br /> _L CLOTHES WASNER WOOD STOVE <br /> URINAL � <br /> 1 METAL FIREPLACE 8 CHIMNEY —' <br /> ORINKING FOUNTAIN FIfiEPLACF IIJSERT <br /> FLOOR DRAIN HEAT PUA1F <br /> BACKFLOW PREVENTERS _],_ GAS PIPING I <br /> ROOFDRAINS—RAINLEADERS EXHAUSTFAN � , <br /> SINK�SERVICF—BAR,ETC.) <br /> _ SU6TOTAL 5 SUBTOTAL S � I <br /> ' PEfiMIT 5 PERMIT $ <br /> TOTALfEE S 10TALFEE S <br /> FRONi5E1�'� � qEAR5E16AGN SIOESETB�CN PUNCNECKNUM6E0 iEE BECEIPTNO. <br /> 20 ' � �a a3�� � , <br /> USE2� �oranea vacaNtsirE FEES VALUATION FEE <br /> �� ves n No { <br /> TYPEOFCON51. OCCUPANGYOPOUP NO-0FOWELIINGW11i5 - ���ILDING Y� [� 86 �� �G <br /> �Y <br /> RLLOWAOIE/ACIpAI, � <br /> _,�—(1 �' 3 I PLUMBING ...�� �. <br /> sizeoroino Hoorstomes o;n+r OCGLORD -- -��---�--- -'----��--� <br /> Z�79 SFt u r MECHANICAL 1 � <br /> S Z 7CN ',�iQ �(_�L� <br /> ��eic��G2 �no� OTHHI <br /> FIRESVRINN�ERSREOUIRED uves i o LV °TAT[GVILDINGSJRCHARGE U /'� <br /> _—.'___ —L-41- <br /> STl.TC ENEFGY SURCHANGE • <br /> pPPUGAiION PGG pY PLR15 APPR 01' —�- -- <br /> �N, aueur,vro:,Ks <br /> N 'I'0'I�S,L <br /> . . .. . . . , . . . . . . � �� <br />