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�r151� 23q 1' i <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> CIl Y OF I_ ERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br /> 1-1 DEMOLITION IKI COMBINATION IR BUILDING kI MECHANICAL xl PLUMBING 11 SIGN <br /> PROJECT ADDRESS <br /> OWNER MAIL ADDnE!S CRY 711, PI1oNF <br /> SelErf "mes Snr.J.281_1 8th Ave IV I A-201 Everetii, FIA 98204 2o5/Sl 1-90➢i_ <br /> TENANT MAII AGTKIf55 CITY ZIP F119141' <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> 1Select Ha11es, Inc. 19A11 8 h Ave, W #A-:201 Everett, WA 98204 206/5.13-900(, SFTPf-TT110KN <br /> MECHANIC,ICONDIACTOR MAIL ADDRESS CITY ZIP PIICIIF. STATE LICENSE/ <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> CONTRACT PRICE OF WORK <br /> -�A��� HEATING SYSTEM: DdG)1S fl ELECTRIC fl <br /> SCDE RIBS Wd1K ANoO SQUARE FOOTAGE INVOLVED CONTACT PFRSON AND PHONE NO <br /> Construction -9005 <br /> Beverly King 206/513-9006 <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOS,DISE OF BUILDING 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 /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEGAL DESCRI TION OF PROPERTY ISNOWN BELOW OR AnACII TWO COR SS) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 1'O GIVE <br /> LOT BLOCK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> Merrill Creek Gardens DIV. 1 PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> PARCEL TAXI D.NUMBER CONT ACTORS LAW 18.27 RCW AND 298.200 WAC. <br /> Select Banes, I/n�c..I <br /> CONSIRlIC710N LOAN LENDEN.ADDRESS.TELEPHONE RIMIER XBV: --^ ( JC.CL.L�. •�(1 •` <br /> SIGNAIURE �� —` DATE <br /> CITY BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> a, WATER CLOSET(TOILET) r AIC—AMNDLG UNITS—H.P. ' <br /> 1 BATHTUB _ 1 FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> a, LAVATORY(WASH BASIN) 1 HEAT PUMP - <br /> 1 SHOWER UNIT HEATERS—B.T.U. M <br /> 1 KITCHEN SINK 8 DISP i CLOTHES DRYERS i <br /> DISHWASHER r VENTILATION FAN <br /> LAUNDRY TRAY I RANGE HOOD I <br /> CLOTHES WASHER r WATER HEATER _T <br /> URINAL ' WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIREPLACE(WOOD BURNING) �— <br /> FLOOR DRAIN 1 FIREPLACE INSERT(WOOD BURNING) ' <br /> BACKFLOW PREVENTERS RAS FIREPLACE ; <br /> SINK(SERVICE—BAR,ETC.) r GAS RANGE r <br /> ' GAS PIPING ' <br /> 1 EXHAUST FAN 1 <br /> 1 1 <br /> I r <br /> r 1 <br /> , 1 <br /> _ SUB TOTAL S ' SUB TOTAL _S <br /> PERMIT E r PERMIT $ 1 <br /> TOTAL FEE S ' TOTAL FEE E ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SFTRAQK- REAR SF.TB,YCK SIDE SETIjACK PLAN CII CK NUMBER rIr RECEIPT NO <br /> I A7 5/ S 70 10 )7 /,? 3/ 1n <br /> USE ZONE�� Z�Z LOT AREA VACANT SITE FEES VALUATION FEE <br /> E - yi•L�) y ff.C) fES 11 ND BUILDING rO <br /> IIEIGIIT LIMITATION �b" NO.Or DWELLING SIZE Qr RTOGn <br /> UNITS I DI SF G LIVIA�T• + PLUMBING <br /> 2 GG <br /> OCCUPANCY I NO OF STORES OCCUPANT LOAD BASEMENT MECHANICAL <br /> GROUP <br /> I N 4 TTYES w<1 -- <br /> FIREALARMREOD REASON ADDITIONAL PLAN CHECK <br /> t?KLOTUER <br /> FIRE BP INED READ REASON <br /> J STATE BUILDING SURCIUROE /G <br /> TYPE OF CONST PLANSArrRGVEDBr CITY S OF PUBLIC WORKS ) <br /> J� TAX CODE I 3105 TOTALOCAL A <br /> �' ,jDATE 2. 2/'/ IS S <br />