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APPLICATION FOR CONSTRUCTION PERMIT <br /> CITY OF EVERETT • RDIVISION <br /> 3200 CEDAR STREET• EVERETTETT, WA WA 98201 • 259-8810 <br /> I1 DEMOLITION I,4 COMBINATION lit BUILDING kl MECHANICAL kI PLUMBING I I SIGN <br /> PROJECT ADDRESS <br /> / / 7 r81` p l 5 u> <br /> OWNER MAN AUbnF S C IIP ZIP PHONE <br /> ISPENA1Ni1-FrHrnI.es' Inn x,2811 8th Ave W RA-201 Ey.�rQtt,-- lK_9-8ZOA— -206/513�9fl6 <br /> MAIL AINKIESS CITY ZIP r110NF "— <br /> AnCl11TECT DR DE9GNEn MAIL ADDRESS III ZIP r11GNE <br /> GENERAL CONT ACTOR MMLADDLIESS CITY 71r PI ZONE STATE LICENSE <br /> aelect HaMSL, T�2811 A h Aire W 9A-201 Eb r•FftF 4fi 98204 206ip�p <br /> MECHAMCAL CONTRAC7011 MAIL AfXMF.55 CIIY 513_9.006- SRTF-rT110KN <br /> 71P PRONE STATE LICENSE F <br /> PLUMBING CONTRACTOR MAIL ADDRESS CIIY ZIP PIONF. STATE LICENSE <br /> CONTRACT PRICE OF WORK <br /> V��yRK QOID HEATING SYSTEM: '+�1 GAS 1-1ELECTRIC1-1DEBCRIBE VNSOUAnE F007AGE INVOLVED CONTACT Pt nSON AND PKNIE NO — <br /> Obrlstruresidence _Randy Clark 206/513-9005 <br /> Beverly King 206/513-9006_ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILDIIKT APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> Single family dwelling PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> lEOAL DESCRIPTION OF PROPERry ISIIOWN BELOW nRAHACH TWOCO{'IES) WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> PERMIT DOES NOT PRESUME TO <br /> LOT .T BLOCK or_ AUTHORITY TO GRANTING NOT, THE OF A <br /> VIOLATE OR CANCEL THE PROVISION OF AINY <br /> OTHER STATE OR LOCAL LAW THE <br /> Merrill Cek Gardens DIV. 1 PERFORMANCE OF CONSTRUC ION.�THAT II AM AUTHORIZED BY <br /> r- THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX I D.NUMBER CONTRACTOf i LAW 18.27 RCW AND 290.200 WAC. <br /> Select i1cmes, Inc. <br /> CONSTRUCTION LOAN LENDER.ADDRESS.TELEPHONE NUMBER BS/• �i�i D•-A/ <br /> SS' <br /> SIGNATURE • DATE '2 /6 <br /> C17Y'BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> OWATEFRI <br /> E OF FIXTURE OR ITEM FEE NO. !AAIHND <br /> MN <br /> RE OR ITEM FEE <br /> SET(TOILET) I H.P.; 1 —U.T.U. M E.A.(WASH BASIN) , . M I <br /> NK d DISP R ' <br /> , <br /> LAUNDRY TRAY ; RANGE HOOD <br /> CLOTHES WASHER ' <br /> I WATER HEATER , <br /> URINAL ' WOOD STOVE I <br /> DRINKING FOUNTAIN ��- <br /> METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR DRAIN I FIREPLACE INSERT(WOOD BURNING) I <br /> BACKFLOW PREVENTERS ; OAS FIREPLACE ' <br /> SINK(SERVICE—BAR,ETC.) , OAS RANGE , <br /> ' 37VeW GAS PIPING I <br /> NEXHAUSTFAN <br /> IM$ i <br /> SUB TOTAL S 'PERMIT S <br /> ,TOTAL FEE S FOR OFFICE USE ONLY:FRONTSETBACK I REM SETBACP SIDE SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> S S <br /> USE ZO LOT AIIEAVACAN/T�1TE FEES VALUATION FEE <br /> Iq TTYES II NO DNIDINO <br /> REIGHt LIMITATION / NO OF OWELLINO SIZE OF BIqc�a l CJ <br /> uNI I II 3f Lw,.i C..-} <br /> rumnwR <br /> OCCUPANDY NO tN STOWS OCCUPANT LOA BASEMENT MECIIANICAI <br /> GROIIP � <br /> MIS P-401 <br /> FIRE ALARM TIED REASON ADDITIONAL PLAN CRECK 1 <br /> v OTHER <br /> FIRE SPRINKLER RED D REASON 'V <br /> Q STALE BUILDING SURCRAFTOE /y <br /> TYPE OFCONSI PUNS APPROVED BY CITY OF EVERETT rUn11C WOnKS <br /> J 14 LOCAL SALES <br /> II hi DATE L '-+f 95 TAX CODE 19 3105 TOTAL <br />