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APPLICATION FOR CONSTRUCTION PERMIT <br /> CITY OF EVERETT• BUILDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 9001 •259-0810 <br /> CI DEMOLITION Ixl COMBINATION lit BUILDING kl MECHANICAL kl PLUMBING 11 SIGN <br /> PROJECT ADDRESS _ /� <br /> OWNEII MA. g1UnE59 <br /> CITY llr 1'IK7NE <br /> -Sel '^L Hf• ea; r=^.MAIIL:IZ1 � -UIJW ! W AA-Z0J RMx <br /> eti,TENANT - OE69 �U�40.209 .20.6/Si3_20IlCIIv _ <br /> MIDNF <br /> AnCIMECIOn DE910NEn MAILA"L, <br /> CIIr 21P PHONE <br /> - ENEMLCONInACIOR MAL AOU"ESS <br /> CITY 21P PN NNE SIAIE LICENSE I <br /> McClitams, rnn_ 17811 Bill Ave. W. RA_201 F. rAl-1- �.m—y0704 206/517_onph RRtFrt'i11n1eM <br /> MECIIAMCAL CONIMCI00 MAIL AOIXIE9$ <br /> Cltr 71P PHONE SIAIE LICENSE$ <br /> d MIIAIBMG CONIRACTOII MAIL AUbITE99 CITY <br /> ZIP PHONE STALE LICENSE, <br /> CONIMCT PLACE OF W011K <br /> scya"00 HEATING SYSTEM: HGAS p ELECTRIC <br /> 9CRI EWORK AN06WARE iOGTAOE MVOLVEO <br /> CONTACT PERSON ANTI I•IIONE Iq <br /> _Construe Ion of one Nimle isid <br /> Y�� 1TC�F•� -EMx]_v_Clark 06/917_9005 <br /> Beverly King 206/513-9006 <br /> 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> PAMSEO USE OF DWLDIRO APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> Sbnle family wellilla PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEOAL OE9CRIPTION OF PROPEBry ISIIOWN BELOW OR ATTACH IWOCOAESI WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> Lal <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> y5 BLOCK or AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> Merrill Creek Gardens Div. 1 OTHER STATE On LOCAL LAW PREGULATING <br /> FFIFOi1MANCE OF CONSTRUCTION.THAT II AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION 19 MADE AND I COMPLY WITH THE STATE <br /> PAncELTAx I.O.NIlA1BER CONTgACTOR9 LAW 18.27 RCW AND 298.200 WAC. <br /> Selec Iiatles, Inc.D <br /> CON9TRIIC710Nr TENDER.ADDRESS.IELEM"NI1MBEn <br /> SIGNATURE DA E <br /> CI rY BUSINESS LICENSE NU. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> 3 WATER CLOSET(TOILET) 1 _ A/C—A/HNDLO UNITS—H.P. �— <br /> 1 BATHTUB LI FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> 3 LAVATORY(WASH BASIN) 1 HEAT PUMP <br /> 1 SHOWER <br /> ' UNIT HEATERS-B.T.U. M 1 <br /> KITCHEN SINK 6 DISP 1I CLOTHES DRYERS <br /> DISHWASHER ' <br /> _ ! VENTILATION FAN —�— <br /> _AUNDRY TRAY RANGE HOOD i <br /> CLOTHES WASHER ' <br /> ' WATER HEATER 1 <br /> URINAL ' WOOD STOVE 1 <br /> DRINKING FOUNTAIN I METAL FIREPLACE(WOOD BURNING) <br /> — <br /> FLOOR DRAIN ' FIREPLACE INSERT(WOOD BURNING) --~ <br /> BACKFLOW PREVENTERS GAS FIREPLACE 1 <br /> SINK(SERVICE—BAR,ETC.) OA --'— <br /> S RANGE � <br /> ' OAS PIPING 1 <br /> 1 EXHAUST FAN - <br /> - � 1 <br /> 1 <br /> 1 1 <br /> SUBTOTAL f ' SUBTOTAL f ' <br /> PERMIT f _- PERMIT f I <br /> TOTAL FEE f ' TOTAL FEE S IFOR OFFICE USE ONLY: <br /> FnONT SETBACK nEM SF*R!^K SIDE SEtB <br /> • �J � � MAN CIIECK.LNMGF:O FEE RF.CEIPTNO. <br /> U$EZ ,5L, LOTAnEA VACA SITE FEES VALUATION FEE <br /> ��7��`.�S/ ❑YES M 110 <br /> BUILbING <br /> HEIGHT LIMII�N J NO Or DWELLING SIZE OF SLOW <br /> 8 UNITS ZL�tu Sf LLvI,.I(, } <br /> i.t f Ci.1a.GC. ' PLUMD <br /> OCCUPANCY NO OF$TOWS OCCUPANT LOAb BASEMENT / MECIUMCAL <br /> N //� FI YES 040 — <br /> FIGEALAnMnEOD REASON ADDI TIONAL P•AN CHECK <br /> FIRE 6I'RINKLEn bEODmEnD REASON _ <br /> STATE BUILDING LNnC11AnOF <br /> IrrEOFconsr PLANS nrrnovLED�Br CITY OF EVERETT PunucwLmKs <br /> J/ L LOCAL SALES l <br /> VAIE 6�Z S�rjrj TAX CODE IS 9105 TOTAL Q <br /> 4 <br />