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j�.-�I 5 /C i L �1 /�I �/ C� / , <br /> APPLIIC�4T10(V FOR CANS1'RU�TIpIV PER�91T <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259 d810 <br /> i l DEMOLITION �I COMBINATION f�t BUlLDING kl MECHANICAL kl PLUMBING fl SIGN <br /> PROJECT ADDRESS 'r�`— <br /> 5�il� �� � �'l Sr,J <br /> OWNER MnILR�Df1E5S CIIY IIP PpONE <br /> Galrx�t ur,mc Tn,• �1.�}]� nve. W Hr1-201 Everett; N]A nR704 2�Q6/513_g006 <br /> IEN�NT MNLA�Of1E5S CIiY 21P PIIONE <br /> A(1CIIIfECTOIl0E51GNER MN�AO�RE55 CIIY ZIP p110NE <br /> GENER�LCON�f1��TOR MAII�DDf1E5S Cltt ZIP PHONG SfAIELICEN5E1 <br /> -S��e-�t-lis�e.�Inc�12&1]._ et1, Av� w #A- ot rv r +, 4� 9A�04 7nti�51� enn� SI'TFf'I'Tl l(IiCN <br /> � MECNANIC4LCOATRAf.TpR MAILAUDRESS CI1Y ZIP p110NE SIAIELICENSE/ <br /> I'LUfABItlGCOIlTflACT7� MAIL�DDPESg CIIV ZIP PHONE ST�IEUCENSEM <br /> CONtRACT PPICC OF WORK <br /> nnn n HEATInG SYSTEM: �3j GAS O ELECT.RIC ❑ <br /> U SCqI E YOR AND SOUME FpOTAGE INVOI.VF.D CONiACi PFRSON AtlD PI IOIJE NO. <br /> Construction of one sin le amil esidence d Clark 206 513- <br /> _ Beverly King 206/513-9006 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PPOPOSEDUSE OF OUILDIN� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> Slilql2 fdiN.ly dWEll]Si PROVIS�ONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGALOESCRIPTIONOFPROPERTY�SIIOWNBELOWORATfACfITIVOCOPIES) NOT. TFIE GRANTING OF A PERMIT DOES NOT PRESJME TO GIVE <br /> � ior CoS BLOCK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTFIER STATE OR LOCAL LAW REGULHTING CONSTRUCTION OR THE <br /> Merrill Creek Gardens D1V, 1 PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE I <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WH�CH �� <br /> APPUCATION IS MADE AND I COMPLY WITH THE STATE II <br /> PABCEL TAX I.D.NUMBER CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. � <br /> Select anes, Inc. '/ <br /> CONSTRUCTION IOAN LENDER,AODqE55.TELEPNONE NUMBER xBv� ���L�a� ?�� ��7,[,/C�C � <br /> SIGNMUAE D�IE � <br /> GiY Ol19NE55 LICENSE NO. � <br /> PLUMBING M1IECHANICAL ' <br /> NO. TYPE OF FIXTURE OR ITEM FEE . NO. TYPE OF FI%TURE OR ITEM FEE <br /> , 3 WATEF CLOSET(TOILET) � NC-A/HNDLG UNITS-H.P. —�— <br /> BATHTUB ' 1 FORCED Alq SYSTEMS-B.T.U. M E.A. � <br /> - ' i <br /> 3 LAVATORY(WASH BASIN) i HEAT PUMP � <br /> Q SH04NER � UIJITHEATERS-B.T.U. M � <br /> 1 KITCHEN SINK 8 DISP � 1 CLOTHES DRYERS � <br /> 1 DISHWASHER � �� VENTIIATION FAN �— <br /> LAUNDRY TRAY ; 1 RANGE HOOD � <br /> 1 CLOTHES WASHEH � 1 WATER HEATER � <br /> UR�NAL � WOOD STOVE � <br /> DRINKING FOUNTAIN i METAL fIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS � � GAS FIREPLACE ' <br /> � <br /> SINK(SERVICE-BAR,ETC.) i GAS RANGE � <br /> ' $C9- GAS PIPING � <br /> i EXHAUSTFAN ' <br /> i <br /> / � i <br /> � � <br /> � , <br /> � i <br /> SUB TOTAL $ - � SUE TOiAL S ' <br /> i <br /> PFRMIT $ i PERMIT $ � <br /> TDTAL FEE $ � TOTA�FEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRGNT,SET��K� FiEAfISETB�N SIOES[��BFCK PL�NCIIECyyf/U�pE FFE �/, RECfi���O. _�� <br /> � / ,S/ 7� �( v o�7 <br /> USEZ� � LOTAREA VACANTSITE FE 5 VALUATION FEE <br /> � � l� �80� .erves n r+n nuaon�c q,Z c11 �! )� ' � <br /> � <br /> HEIGNtLIMITATION NO.OFOWE,LING SIZEOFBLWrt.I. �� i <br /> 261 � UNI7S I 'L�c�o SF LIVWv t p�NA01NG <br /> �� 46Z Sr (ina4ac <br /> OCCUPRNCV NO OF Si0BIE5 OCCUPANi LOAD BASEMENT (;�,�' <br /> Gfp10'UP q � MEC1141JICAL <br /> 1-� �'1') G .Q ❑YES N'NO — — � i <br /> FIREALAPMREO'D REASON A�OIiIONAIPLANCIIF.CK ___i <br /> (� i <br /> FINE6PRINK�qREO'0 P6450N OiHEA L%:��1l,/�/� -- /�'\ � <br /> i• ir <br /> _ <br /> ��p srnre om�oiNc su�icunnce l ;,;�., <br /> TYPEOFCONS! PLANSAPPPOVEOBY - i � <br /> J1, C!TYOFEVERETT PUOLICWORKS �'�! ); <br /> f'' LOCAL SALES "-" <br /> �"IJ ��TE s 3 9S TAX COUE IS 3105 TOTAL /� i ;rj� <br /> 7�- . <br /> � � <br />