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AP72LICATIGA FOR CONSTRUCTION PERMIT4�ff CITY OF EVERETT • BUILDING DIVISION <br /> 3200 CEDAR STREET• EVERETT,WA 98201 • 25£ 8810 <br /> I I DEMOLITION LAI COMBINATION Ik BUILDING k1 MECHANICAL RI PLUMBING I I SIGN <br /> PROJECT ADDRESS (70 <br /> S ui I-,- <br /> pi. <br /> DwNEn Mnn aTwnrss <br /> Lnr ZIP PHONE <br /> 1�R71 Rrh AT. W NA-201 Preset, . WA 98204 206/Fl z-ann6 _.— - <br /> RPIP[-t NrmPCI_y.21C. r.IIY 71P rI1ONF. <br /> 1ENNIT MAIL AIXNiF.54 <br /> AIRCIPIECT OROESIGNER MAIL ADDRESS <br /> PHONE <br /> 7.IP PHONE STATE LICENSE. <br /> GENERAL CONTRACTOR MAIL ADDRESS <br /> CITY <br /> .,e Djeret IA Wl4 2069 �` coTsrrTl l nKN <br /> SPle. Y I{aRp„g� Tnr 19R71 Rt_h A W kA-20TY t+� PHorIF STATE LICENSE. <br /> MECHANICAL CONIAACT01 MAIL ADDRESS <br /> cnr ?IP <br /> PLUMPING CONTRACTOR MAIL ADDRESS CITY IIP PHONE STATE LICENSE/ <br /> CONTRACT PRICE OF WORK HEATING SYSTEM: GAS rl ELECTRIC <br /> [I- <br /> CONTACT PERSON AND PHONE NO <br /> 0 SCn EWORK AND SWARE FOOTAGE WVOLVEO YPS{ <br /> Construction of SOP single family -denm <br /> Beverly King 206/513-9006 <br /> I HEREBY CERTIFY THAT I HIKE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROPOSED USE OF BUILDING PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> Single nmUONOFfamily dwell WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEoa OEscrnoT we Ts11owN SELow OR ATTACH TWO COPIES) NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> M <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> LOT BLOCK OrOTHER 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 /> _ CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> PARCEL TAXI D.NUMBER Select Hanes, Inc. <br /> CONSTRUCTION LOAN LENDER.ADDRESS,TELEPHONE NUMBER XBV:SIGNATUITE DAZE <br /> CITY BUSINESS LICENSE NO <br /> PLUMBING MECHANICAL <br /> FEE NO. TYPE OF FIXTURE OR ITEM <br /> FEE <br /> N0. TYPE OF FIXTURE OR ITEM , <br /> AIC WATER CLOSET(TOILET) I C D UNITS—H.P. <br /> AIR SYSTEMS <br /> I <br /> 1 ' 1 FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> BATHTUB <br /> LAVATORY(WASH BASINI ' <br /> HEAT PUMP <br /> I <br /> 1 SHOWER ' UNITHEATERS-B.T.U. M <br /> , <br /> ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP ' I <br /> 1 ' VENTILATION FAN <br /> DISHWASHER <br /> LAUNDRY TRAY ' RANGE HOOD <br /> 1 CLOTHES WASHER I WATER HEATER <br /> 1 WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN , FIREPLACE INSERT(WOOD BURNING) ' <br /> FLOOR DRAIN ' <br /> BACKFLOW PREVENTERSFIREPLACE ' <br /> OAS RANGE <br /> SINK(SERVICE-BAH,ETC.) , - _pqg PIPING <br /> EXHAUST FAN ' - <br /> , <br /> SUB TAL <br /> SUB TOTAL E PERMIT $ ' <br /> PERMIT $ <br /> TOTAL FEE <br /> TOTAL FEE S ' S <br /> FOR OFFICE USE ONLY: FEE�� RECEIPT NO <br /> / ruNCIIECK IMnEn <br /> FRONT SETBACK REAM SETBACK SIDE SETBACK _ �2 <br /> LOTH VACANT SITE FEES VALUATION FEE , <br /> use NE fL � SY OZ- <br /> nrEa n No pun0n+a <br /> HEIGHT LIMITATIOY NO O DWELLING 512E OE BLOGrU <br /> HNITS (IOZ a1 F I-14/A/�j+ PLUMBING <br /> OnCUPANCY NO O STORIES OCCUPANT LOAD BASEMENT MECHANICAL <br /> N ES n NO <br /> ADDITIONAL PLAN CHECK <br /> FIRE AIARM REO'0 REASON <br /> OTIIEA _ <br /> FIRE SPRINKLER REU IJ REASON STATE BUILDING SURCHAnGE <br /> TYPE OF CONST. runsAFiZv�BY CITY OFEVERETT PUBLIC WORKS <br /> 10 LOCAL SALES _7 <br /> -/.� OATF 3 A049 _ TAX CODE IS 3105 1 TOTAL <br />