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APPLIC.�.TIUW� ��IT N�TR�CTI�N <br />Ihe Evorgreen � yi1i1� <br />GTY OF � <br />everett <br />BUILDING DEPARTPr1ENT TO BE COMPLETED IN INK— PLEASE PRINT <br />259-8810 <br />C.I�v l��• r�loNE <br />OW NEII MMl �OO�E SS 8 2 7- 319 6 <br />MUKILTEO, Wn 982;5 <br />SELECT I�OMES, INC. PO BOX 708 -- ------ <br />_._________— n+rnnnoness cirv _.__...__ zin_ __ puoHe <br />IENANI <br />n/a -- CIIY ..__— ]II` PIIONI' _ —._."_ __ __... <br />RtICHII[LiO�0E51GNEfi MAILADClIE55 <br />n/a - P80N[ --- -- I.ILFNS[ + <br />MPItRDOBE55 f.liv ll� <br />Ger+E�a��o�imncton DiUKILTEO� P1A 98275 fl27-6195 SGLE(1-1I11_.OKP: <br />SELECT ❑OMGS, INC. PO IIOX 708 ------------ <br />. ._..___"" c�tv ]Ir- rnOUE Ucf.NSE� <br />ALUMBINUGONiRALtOR MRILFOO�ESS <br />GIIV 21P -- PIION[ ----IIf,FNSF. � . <br />G�U74�3OF WOPN <br />IS NEW ❑ ADDITION ❑ ��TERAI�9N ❑�7EPAI(1 ❑ OEMOUTION co❑ncW C��o J�' ni rior F oSE�T ❑ E�UILOING RELOCATION <br />TENAMLIMPROVEMENfO�INi[NORRE1dOnr�,�NLV <br />Randy Clark 348-1320/a27-8196 <br />cor+*nacrraicForwonK�. – StlYfl 8�7-$1��& <br />____............,� .unenunnc mo1�GE INVOLVfO Greg <br />sin le fami]y residen!:e <br />LEORL GESCRIPt10H OF PRO�FRLV IS��OW N OFLOW O� Allat' � <br />LOt_ � BIOGR__— �� —�- <br />;` <br />��. PROJLCU�OnES <br />I �� <br />. . PLUNiBINO <br />NO. <br />g wa� i <br />KITGHE� SINKB DISP. <br />DIuHWAS!iER <br />L�UNDRY�tRAY <br />DRAINS— <br />crav�r.F — <br />{ <br />FPONi SEi9AGK/ <br />�LD <br />USE Z <br />; �' <br />� rrre OF cous? <br />n��owne�eucrw� <br />, siz€ �r o�ec� <br />u <br />familv res <br />I HEPEBV CEf7TIFY TIiAT I HAVE READ AN D EXAMINEU TNIS APPLICA710N AND <br />KNOH"HE SAME TO BE iRUE AND CORAECT, ALl PROVI:410NS OF LAWS AND <br />OFlDIM1AN^F.S GOVERNING TIIIS NPE OF WORK WILL BE �OMPLETED W�T�i <br />WHETHERSPECIFIEDHER[INORNOT.THEGRANTINGOf APERMITDUES NOT <br />PF7ESUME TO vIVE ��TI IOf717Y TO VIOLATE OR C�NCEL TVIE ^^^VISIONS Of <br />FO�MANCE OF CONSTRUCiION HE T�1 AM AU HORSZED BVOtHE�OWNE� �� <br />THIS PFOP[f7TV T PCRFOf1M THE WORK FOR WNfCH APPLICATION IS MAf11E <br />AN� I COMPLY ITH THE ST�TE CONTRAC70RS LAW 10.27 RCW AMU <br />296.^•00 W�C. <br />sarvniuneorc nn oi�onnun�omz�oncer+� on�e <br />SeleG t mes, Inc. <br />X / � /'�'✓�� <br />���ICA 5 r 51 .SLCENSEN�.4N�FIUSINESSNPME <br />MECHANICAL <br />ITEM FEE NO. T/PEOFEOI�IPMENT <br />q/C— A/HNDLG UNITS-- H.P. <br />1 FOF7CED AIR SYF'.G�nS=BT.U. M EA <br />�ci UNITH6ITERS—B.T.U. M <br />j CLOTHES OfiYERS <br />— G) �. 3 VENTILATION fAN <br />—�i= 1 1 RANGE HOOD _ <br />SUBTOTAL 5 <br />TOTAL <br />FIPESPNNNLERSRf0UIf1E0 I.I YES._ <br />pPf LIGAIIUN ACG OY <br />� <br />i <br />I� -.. . .;'k.. . ' . . ... � <br />Z � �Y <br />N <br />❑ NO <br />WOOD STOVE <br />METAL FlF7EPLACE 8 CHIM <br />FIREPLACEINSEFT <br />HE�T PUMP <br />GAS PIPING <br />FXHFUSTFAN <br />PERMIT <br />FEES <br />aui�owc <br />PLUMBING <br />MECHANICAL <br />OThIER I�I � l'�C�L_ <br />STAlE BUILDING SUPCNAfiGE <br />STAiE ENEFGY SURGHA(iGE <br />PU�LIC WORKS <br />TOTAL <br />PF <<S' <br />$ --LLLL��G1-- <br />s <br />S � <br />IECEIPf NU. <br />FEE <br />(nLZ -f/-D <br />�D� _Up <br />�1 Q_ �D <br />I �(_ (� � <br />�f -N <br />� V � <br />���(0 I,,2 <br />