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APPLICATION FOR CONSTRUCTION PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br /> f-1 DEMOLITION fxl COMBINATION IR BUILDING kl MECHANICAL kl PLUMBING i I SIGN <br /> PROJECT ADDRESS ' 2,Q s <br /> 5�+` Y'I s uJ <br /> OWNER MAIL ADDRESS CRr 71P PHONE <br /> . tnrr urn,.�r r C 12p11 p h At k' 1A-201 EL'ererr <br /> TSeENANTMAl1.ADDRESS . 711111-98204 206/579-annF <br /> CITY zIP <br /> ARCIIITECTOR DESIGNER MAIL ADDRESS CITY IIP PIIONF <br /> GENERAL CONTMCTM MAILADDLIF.SS CITY zip PHONE STATE UCENSEF <br /> Select Hrnlec, Inc*- 12811 R h AVe- .W. #A-201 Evererr� WA L18 .04 2nF/!;li-O_nnG_ RF.iFITTllnitra <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE• <br /> PLUMBING CONTRACTOR MAIL ADDRC.iS CITY ZIP PHONE STATE LICENSE A <br /> CONTRACT PRICE OF WORK <br /> 40�OAO 00 HEATING aiSTEM: PQ GAS C)ELECTRIC C7 <br /> 0 SCRI E WORK AND SOLARE FOOTAGE INVOLVED CONTACT PERSON AND PIGNf.NO <br /> Construction of on c;nrTte family residence -Randy Clark 206/513-9006 <br /> Beverly King 206/513-9006 <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PRGPGseD DEE OF BUILDING — APPLICATION AND KNOW THE SAME TO BE TRUE AND CORF'FCT,ALL <br /> Single family dwelling PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTIONOF PROPERTY IBHGWN BELOW OnAi1ACl1 TWO COPTCSI WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT -*,kT _BOCK or AUTHORITY TO VIOLATE OR CANCEL THE PR )VISION 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 I COMPLY WITH THE STATE <br /> PARCEL TAA I.D.NUMBER CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br /> Select Hanes, Inc. <br /> CONSTRUCTION LOAN LENDER.ADDRESS.TELEPHONE NUMBER XBV: A C � A-1993 _ <br /> SIGNATURE E 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 /> 3 WATER CLOSET(TOILET) I A/C—AMNDLG UNITS—H.P. I <br /> 1 BATHTUB ' L FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> 3 LAVATORY(WASH BASIN) , HEAT PUMP , <br /> 1 SHOWER ' l;.'1!THEATERS—B.T.U. M I <br /> 1 KITCHEN SINK 6 DISP i -1 CLOTHES DRYERS <br /> DISHWASHER 1 VENTILATION FAN i— <br /> LAUNDRY TRAY I RANGE HOOD <br /> CLOTHES WASHER 1 WATER HEATER , <br /> URINAL ' WOOD STOVE I <br /> DRINKING FOUNTAIN , METAL FIREPLACE(WOOD BURNING) ; <br /> FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) I <br /> BACKFLOW PREVENTERS OAS FIREPLACE ' <br /> SINK(SERVICE—BAR, ETC.) 1 GAS RANGE �— <br /> ' YC6 GAS PIPING ' <br /> 1 EXHAUSTFAN , <br /> I , <br /> I , <br /> SUB TOTAL S ' SUB TOTAL $ ' <br /> PERMIT <br /> $ _ 1 PERMIT $ I <br /> TOTAL FEE S ---� TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBA K / REM SETBACK SIDE SETBAC� / PLAN K NUMBER FEE <br /> USE ZON((//CJp�—/ LOTARF VACANT SITEFEE VALUATION L FEE/ <br /> nYEB n NO BUILDING <br /> HEIGHT LIMITATION NO OF OWELUNO SIjjEE Of BIDG/fI <br /> UNITS YI,#& SP Ll..'Ma. <br /> 1245� m2 s6 GAaAGE PLUMBING77 <br /> OCCUPANCY 1 �PNO OF STORIES OCCUPANTLOAD BASEMENT / MECHANICAL <br /> P•"3 N 1A nYE3 fYNO <br /> So <br /> FIRc ALARM,�RE0M'0 REASON ADDITIONAL PLCNECK <br /> 14O OTHER / <br /> FIRE SPRINKLER REGO REASON <br /> p STATE BUILDING SURCHARGE �j <br /> TYPE OF CONST PLAN=BYY OF EVERETT PUBLIC WORKS J <br /> .� OCAL SALESX CODE 15 3105 TOTAL �) <br />