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� L �c2 --3� ���Sic �� � � ' � <br /> APPLICATIOi�I FOR GONSTRI�CYION PERMIT <br /> CITY OF EVERETT • DUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 •259-8810 <br /> ❑ DEMOLITION �1 COMBINATION f� BUILDING k� MECHANICAI �I PLUMBING ❑ SIGN <br /> PROJECT ADDRESS � � <br /> s�� � �� Pl. S, W. , c-vrrP f/ <br /> cwr�en Mnanvon[ss cirr zi' �IIONE <br /> Ralar� urn�aa rnr• 12811 Sth Ave. IV #A-201 Gverett- F1A 9820�,Q(/513-9006 <br /> ' tENAN� ���—MAlI.A0D4E55 CIIY ZIP PIIONE <br /> A(iCIitlECiOfiOESIGNER MAILAU�RE55 CI1Y ZIP PIIONE <br /> OENEMLCON1tlRC70R MAIL�DUf1E55 Cliv ZIP PIIONE Sf�TEUCf:NSE� <br /> � SeJP��_an�,� Tnc. 128 1 8th Av .. W. !lA-201 1�v rett, V]A 98204 206/51"t-9006 RF.T,F.c'TT110tN <br /> MECHANICAICONIfiAC10P MPILAU�RESS qtt 2IP PIIONE SiNEUCENSE� <br /> PLUMBINOCORIR�CTOP M�IIADDf1E5S CIfV ZIP Pf10NE STAIEUCENSE� <br /> CONTRpCi�I110E OF WOAN <br /> �� ��� HEATING SYSTEM: bG GAS ❑ ELECTRIC O <br /> 0 SCREE YlOf1N ANO 50U�RE FOOT�GE INVOIVED � CON7ACf PERSON�NO PIIONE N0. <br /> Construction of one in le amil esid nce It�ind�Clark 206/513-9006 <br /> Beverly King 206/513-9006 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILbINO APPLICATION AND Ri:�W THE SAME TO BE TRUE AND CORRECT.AlL <br /> PROVISIONS OF LAWS Ah0 ORDINANCES GOVERNIN6 THIS TYPE OF <br /> Sincrle familv dwellincr WORK WILL BE COMPLIED WITH WfiETHER SPEC�FIED HEREIN OR <br /> � LEOALUESCBIPIIONOFPpOPEPTY�5110WNBELOWORATT�CHTYOCOPIES) NOL THE QRANTINO OF A °ERMIT DOES NOT PRESUME TO OIVE '� <br /> tot �^� BIOCK or AUTHORITY TO VIOLATE JR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW FE6ULATINO CONSTRUCiION OR THE <br /> Mesrill Creek Gardens D1V. 1 PEPFOAM�.NC[OF CONSTHUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />� APPIICATION IS MADE AND I COMPLY WITH THE 3TATE <br /> PARCELTA%I.D.NUMBER CONTRACTOF3 LAW 1827 RCW AND 296200 WAC. ' <br /> Select I s, Incq. <br /> CONSTRUCiIO,�Nl1OANlEN05R.A0DRESS.TELEPHONENUM0E11 BV, ��� / l� G�ZJ/�� � <br /> /V O� v SIQNAIUf1E DAtE <br /> CI�Y DUSINESS UCENSE N0. � <br /> PLUMBING MECHANICAL '� <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> 3 WATER CLOSET(TOILET) � NC—A/HN�LG UDIIT�—H.P. � <br /> � BATHTUB � 1 FORCEDAIFSYSTEt.75—B.T.U. M E.A. � <br /> 3 LAVAT:IRY(WASH BASIN) i HEAT PUMP �_ <br /> SHOWER � UNII'HEATERS—B.T.U. M ' <br /> 1 KITCHEN SINK&DISP i �. CLOiHES DRYERS i <br /> 1 DISHWASHER � VENTILATION FAN _� <br /> i <br /> LAUNDRYTqAY � 1 RANGE HOOD i <br /> 1 CLOTiiES WASHER i WATEP HEATER � <br /> URINAL ' WOOD STOVE ' <br /> DRINKINQ FOUNTAIfJ i METAL FIREPLACE(WOOD BURNING) i <br /> --+— <br /> FLUOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS�IREPLACE _�_ <br /> SINK(SERVICE—BAR,ETC.) i GAS RANGE � <br /> ' Yes GAS PIPING ' <br /> , ? extinusr rnN � <br /> , � <br /> � � <br /> � � <br /> — - , -- , <br /> sue rorn� s ; sue Torn� s � <br /> PERMIT $ —i— PERMIT $ � <br /> TOTALFEE $ � TOTALFEE $ � <br /> FOR OFFICE USE OPJLY: <br /> FRONT SElOACK / PEAR SEIU�CR S�DE SE79�CN PL/�N CIIECN HUM�ER PEG RECEIPT NO. <br /> � j *� / 1 <br /> +.> '/ i '- '� <br /> usezoNe lO7ARE� vncat+rsitE FEES VAWATION FEE <br /> � 3 � ❑YES f.l NO BUILbUlO 5 �3� J 7�i. `�; � <br /> IIEIQIIT IIMITATION J NO.OF OWELLINO SIZE OF UlDO/LI. J ' <br /> ZO _ UNIIS /$t2 S!- Civ.iJG t PWMOING / � <br /> � sF G�ea��. <br /> OCCIIPANCY 1q.Of 570111E5 OCCUPANT LC:1D 6ASEMENT /� <br /> QROUP � � MECH�NICAL //'� <br /> . „�,� � ❑YES (YND � <br /> FIqE�IARM fiE00 I1E�50N �DDI110NAL PL�N CIIECN <br /> O711Ef1 <br /> FIflE SPRINKLER pE0'D REASON <br /> S7ATE OUIl01NQ SUIIGHAlIC1E `/ � <br /> TVPE OF CONST. PLANSAPPROVED BV ��� <br /> 1 CITY OF EVERETT ruoucwonKs <br /> J I� LOCAL SALES ,-� � <br /> .JT'—'lJ urae 6 Le 9 5 TAX CODE IS 3105 70TAL /���I� (iU <br />