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�°� '�'9 <br />APPLICi�,�ION F�R C4NSTRUCTION <br />PERMIT <br />!he Evergreon <br />CITY OF <br />evereit '�°'�"�" <br />BUILDING DEPARTMENT � <br />259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWrv[(i MA!L AOOFE55 <br />GIiY ZIP PIIONE <br />SELECT IIOMES, INC. PO BOX 708 MUKILTEO, WA 98275 827-8196 <br />i[NANi -- MAILP�ORE55 GIiV ZIP � PIION[ �--------��--- <br />�� ���• uv PIIONE - <br />n/a <br />— ---- --- <br />crNcnnico��macroa Mutaoaness __-.___ - . ._ -... . _ -_______.. <br />Crtr zin -rnoNt -_ � ir,i w;� . <br />.`'iELECT IIOMliS, INC. PO IIOX 708 MOKILTliO, WA 98275 827-8195SELECHIllp1(p; <br />MECNANIC/IGONiRACiOR MAILhD�RESS CIiY ZIP PHONC LI��rySE� <br />NLUMBINGCONifiAC10R MAI�ApORE55 GITV ZIP PIIOYE �If,FNSE• <br />__ ---_—_ _ <br />f�,LAX590F WORM <br />LI NEW ❑ ADDIiION ❑ ALTERATION ❑ FEPAIR ❑ DEMOUTION ❑ WOODSTOVE/FRPL INSERT ❑ �UILDING RELOCFTION � <br />CONTRO' PRILEOFWORK <br />construction of sinqle fam' <br />PPOPOSED USE OF 91/iI,DING <br />_ sinqle familv residence <br />LOT� BLOCK OF <br />C�LEh1HAUEn1 HF_I <br />�67 - ;� �� �3 <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />WATER CLOSET (TOILE <br />BATHTUB <br />LAVATORV�WASH BAS <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />LAUNORYTRAY <br />CLOTHES WASHEF <br />DqINKING <br />BACKFI.OW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINKlRFRVICF—R4a Fmi <br />SUBTOTAL $ <br />PE�MIT $ <br />TOIN� FEE S <br />FBONTSEiHACH , REARS[iDACN Slp <br />__ V— <br />usezoNe -- wrnacn vnc <br />�2- i �Z�r <br />rvn(orCONSt of,cuPaNf,vGqoUf' No <br />nu.nwnm[inctuni <br />SIIf OF BIOG NO OI SiOfll[5 �SNi Mi <br />7 <br />�IRESPf11N'�i.1R5RE011lilF� tiv�s iiun <br />er <br />nv <br />�O , <br />R SITE <br />� n wo <br />'DWELIP <br />I <br />On0 <br />r urnrtnn <br />7� � <br />Randy Clark 349-1 20 E'L7-8196 <br />Greg Stirn 8 7-„ — <br />� � S�' � <br />IHEREBVCER7IFVTHATIHAVEREA ANDEXAMiNEDTHI5APPI.ICATIONAND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW S AND <br />OfiDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�C-7ED WITN <br />WHETHERSPECIFlEDHFREINORNOT.THEGRANTINGOFAPERMITDOESIJOT <br />PRE3UME TO GIVE AUTHORIN TO VIOLATE OR CANCEL TIiE PROVISIONS OF <br />ANY OTH ER ST4TE OR LOCAL LAW REGULATI NG CONSTRUC710N OR THE PEF� <br />FORMANCE OF CONSTRUCTION. THA71 AM AUiHCRIZED BY 7HE OWNER OF <br />THIS PRO?ERTV TO PERFORM THE WORK FOR WHICH A�PLIC�TION IS MADE <br />AN� I COMPLY WITH 7HE S7A7E CONTRACTORS LAW 1827 RCW AND <br />296200 WAC. <br />SIGNATUREOFCONTRACIORORAUINOAIZ[�PGENT DAiE <br />Sele t omes, Inc. �,zs�,c�. <br />X � <br />�,_ • / L ,� <br />AV IICANTSCRYfl�J51N[$SI�f,ENSENOAN00U51N[SSN4lAC - <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />A/C — A/HNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS— B.7.U. M <br />UNITHEA7ER5—B.7.U. M <br />CLOTHE3DRVERS <br />VENTILATION FqN <br />RANGEHOOD <br />WATER HEATER <br />WOOD SfOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />FEES <br />BUILDING . _ _ <br />PLUMBING <br />MECHANICpL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STA7E ENERGV SURCHFRGE <br />pI1BLIC WORKS <br />TOTAL <br />PCR�dIT $ <br />TOTALfEE S <br />FEE NEI <br />,�57./,i" <br />VALUATION <br />_�`Lr`lC_/___ __ <br />�� <br />sd <br />