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fheF.vergreen ' �,J�yCTRUCTION � ��� <br />CITY OF <br />�Veie$� PERMIT PERMITNO.. ��5�� <br />25y-8810 <br />❑ DEMOLITION �F COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNFR M11�ILAOORESS CITY ZIP PNON[ <br />SB�ifdiKXH�dI�S{ Select Homes P.O. Box 708 Mukili:eo 9���5 8�7-819F - <br />TENANT MNLAO�fiE55 CIiY ZIP PNON[ <br />ARCHITELTOROESIGNEH MAIIApDRE55 CITV ZIP PHONE <br />G[NEfVALWNTPAGTOR A�41LADflPESS � CIiY ZiP PHONF. LIGENSE�� <br />Owner SELECHIl10KW - <br />h�ECHANiCALCONT1iAC!OR MAILAD�RESS CITY ZIP PHONE LICCJSP <br />CLA55OF WORK <br />Q NEW ❑ ADDITION <br />MNIL AODFE55 <br />❑ ALTERATION ❑ flEPAIR <br />CONTRACT PRICE OF WORK: S � <br />DESCRIpE YJORN AND SOUAP_ POOTAGE INVOLV[D <br />New Construction <br />PROPOSE� USE OF BUILOING <br />Sin le famil residence <br />�EGAL �ESCPIPTION OP PFOPEFTY (SNOW DELOV/ OR AiTACH FOl1R COPIES� <br />�or 19 o�ocK—oF Glenhaven Heiahts <br />J0� A�DfiE55 <br />4931 9th Ave. W. <br />PLUMBING <br />NO. TYPE OF <br />BATHTUB <br />LAV/TORV <br />KITCHEN SINK 8 DI <br />�ISHWRSHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />�RINKING FOUNTAIN <br />FLOOR DRAIN <br />DACKFLOW PREVENTERS <br />ROOF DFAINS - RAINLEADER° <br />SINK (SERVICE - BAR. ETC.) <br />SI1B TOTAL <br />PEHMIT <br />TOTALFEE <br />FROMTSET�ICR R[M SEIBACK <br />20 20—top of slope <br />USE20NE LOTFREA <br />R-1 10,410 <br />ivr�oFra;s7nucnonnuowneiE rva�oFcoNsrauc7iorvncun� <br />V—N V—N <br />SIZE Or' �LDG NO.OF STORIES <br />1728 + 452 gar 2 <br />OCCUPdNCY LOAD FlqE SPFINKLERS REO'D <br />NI� ❑ YES �NO <br />REPSONFORSPRINKLERS <br />APPLICATION ACC. BY FLnNS nPPROVEO eY <br />hi. ^i. I J. H. <br />FEE <br />5 <br />CiTY Z�P <br />❑ DEMOLI'fIDN <br />PHONE UCENSEa <br />❑ BUILDINC. �?ELOCATION <br />CONTACT F[PSON FN� vnUrve Mu. ir u i nen i nnn ..ov� c <br />MECHANICAL <br />NO. TYPE OF EOl <br />A/C — A/NNDLG UNITS — H <br />], FORCEOAIRSVSTEMS—B. <br />UNIT HEATERS — B.T.0 <br />1 CLOTHESORVERS <br />3 VENTILATION FAN <br />j RANGEHOOD <br />1 WATER HEATER <br />WOODSTOVE <br />], METAL FIREPLACE 8 CHI+/� <br />FIf1EPLACE INSERT <br />HEAT PLI14P <br />1 GAS FIPING <br />EXHAUSTFFN <br />Si�E SETBnCK PLAN CHECK NUMBER <br />6 90/23798 <br />VA::ANT SITE <br />FEES <br />�YES ❑ NO <br />a�pu��ti" NooFovrtwncu�+ns BUILDING <br />I2-3 1 <br />PLUMBING <br />YES C�NO <br />MEIGHT li1dITFT10N <br />28 <br />CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />3105 <br />PERMI7S EXPIRE IF WORK IS NOT COMMENf:ED WITHfN <br />180 DAYS OR CEASES FOR MORE TFIAfJ 180 DAYS. <br />FEE <br />h1 <br />5'JBTOtAL S <br />PEfiM1T 5 <br />TOTALFEE S <br />FEE RECEIPT NO. <br />Basic <br />euaomr.cooE FE <br />va <br />s'/R 0.SL3 nn <br />MECHANICAL <br />JTHER <br />STATE BUILDING SURCHARGI <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />ADUIlfSS PILE <br />,Y VALIDATED <br />YOURPERMI'� <br />J�j�ji�� <br />k:{::k:K <br />