Laserfiche WebLink
�.1PPLlC�+iION FOF£ ���BSiRV�C'iIOM <br />PEF��IAI a <br />fhe Evoryreen <br />CITY OF <br />e�erett '�°' <br />BUILDING DEPARTMENT �� <br />259 s8�o TO BE COMPLETED IN INK — PLEASE PRINT <br />OWNER I.IAILADORES$ � pltY 21P PIIONE <br />SEL�CT HOMES, INC. PO BOX 708 MUKII,TEO, WA 98275 827-8196 <br />TENANi MAILROOfiE55 CIiY ZIV PHONE � <br />n/a <br />ARCNITECTORpE51GN6R MRILAOORE55 CITV TIP PNON[ <br />n/a <br />GENERALCONtP4CTOR MAILApDRE55 CITY ZIP PHONE LiCFH'+ � � I <br />SELECT HOMLS, INC. PO IIOX 708 MUKILTEO, WA 98275 827-8196SELECHI]1(1!� <br />MECNANIG�ICONTHnCTDR IA�ILAOOPE55 CITY '� PNONE LiCE��`•� <br />PLUMfiIROCONTRACiOR M0.1LI�ORESS GIiV ZIP PHONE LIf.EN:� <br />IJ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOO�STOVE/FRPL INSERT Q OUILDING RELOCA710N <br />iENANi IMPROVEIAENT OR INiERIOR REMO�EL ONLV CANTACT aFasnr� nun cunuc un — <br />PRICE OF WOFK <br />uction <br />ilv res <br />LOt � �J BIOGK OF <br />�D//— <br />PLUMBING <br />NO. TY <br />WATER CLO <br />OATHTUB <br />.� LAVATORY(1 <br />res <br />Clark 348-1320/827-8196 <br />�,.cy o�.�a.ii oz-r—rsi�'o <br />:e .-'S"S��S�3 <br />I HEHEBY CERTIFY THAT I HAV£ READ AND EXAIdfNED THiS APPLICAT.�it' <br />KNOW THE SAME TO BE TRU F. AND CORRECT. ALL PRO'JISIONS OF LAW. <br />ORDINANCES GOVERNING THIS TVPE OF WORK WIL'_ BE COMP�E7Ef� <br />� WHETHGFSPEGFIEDNEREINORNOT.THEGRAN71N30FAPERMITD01-' <br />PRESUME TO GIVE AU7 HORITY 7p VIOLA7E OR CANCEI_ THE PROVISIO� <br />ANY OTHER STATE OR LOCAL LAW HEGULN ING CONSTRUCYION OR TH I <br />FORMANCE OF CONSTRUCTION. THAT I APA 4UTHORIZED EY THE OWPII <br />THIS PROPERTYTO PERFORM THE WORK FOR WHICH APPL'CATION IS t <br />ANU I COMPLY WITH THE STATE CONTRAC70R5 LAW 18.27 RCNJ <br />296.�00 WAC. <br />SIGt:aiUfiE01'COIlIFACTOBOPAUTNCRqE[lA.[Ni D4iE <br />Seleg� Ho ies, Inc. <br />yj�(�� �i� � <br />�PPLICAN/ITYBUSMESSIICEN$ENORH04LB�ESSN.1 F ��� <br />MECHANICAL <br />/ 'ACy <br />FI)CTUpE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br />>���) S� — A/C—A/HN�LGUNITS—H.P. <br />�G — l. FORCED AIR SYSTEMS— B7.U. M E0. <br />lASIN� _ '_— UNIT HEATERS— B.T.U. M <br />KITCHEN SINKB DISP. <br />O�SHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTI <br />ROOF DRAINS— RAIN <br />51 NK ISERVICE — BAR. <br />�'"- <br />3 <br />9UBTOTAI �� <br />PERMIT 5 <br />TOTAL FEE S <br />IPP SETpACK q10E SETB.�CK <br />ZmI �♦ . <br />IiAR[p yACANTSITE <br />�O � / �S I] NO <br />:CUPAMCYaROUP NOAFDWELLINpUt <br />� y , <br />i <br />1.OFSiORIf.S 95MT. OGGLOAD <br />•Z` � . <br />❑ N", <br />FIRESPRIAKLERSNEOUIRED OYES <br />VENTILATION FAN <br />RANGEHOOD <br />WP.TEF HEATER <br />WOOD STOVE <br />METAL FIREPIACE <br />FIFEPLACE INSEH <br />HE:.T PUMP <br />GAS PIPING <br />E%HAUST FAN <br />SUB TOTAL $ /`� � <br />PERMIT 5 � <br />TOTAL FEE S , . <br />`.'� .?3 SY� s'S '•/.f' :�O/7;; <br />FEES VALUATION FEE <br />eui�oiHa + . � ;a.; S-y ` <br />— /_.. <br />PLUMBING �p <br />MI9CHANIGAL =V _ <br />Ol'HER <br />S1ATE BUIl01NG SURCHAqGE tJ <br />STATE ENERGY SURCNpRGE <br />PUBUC WORKS ��� <br />TOTAL �-� 1 y <br />�7 a,P. <br />�c�t <br />, ' - `� <br />a. •• <br />; <br />, ;; , <br />' 'r,;. <br />, ;:,� <br />