Laserfiche WebLink
APPLICAT ON FOR CONSTRUr TION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BASIC PLAN: CEDAR (CITY NO. 100 ) <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS 0 ELECTRIC Lj — <br /> 259.8810 <br /> I I DEMOLITION lx4 COMBINATION I I BUILDING I I MECHANICAL 11,PLUMBING SIGN <br /> OWNER MAX ADDRESS <br /> CITY IIP NE <br /> PNp - <br /> SELECT HOMES INC. 237 ELM ST EVERETT WA 98203 258-1503 <br /> TENANT MAILADDRLSS <br /> CITY ZIP <br /> PNDNE <br /> ARCHITECT OR DESIDI[R M\II ADDRESS <br /> CITY ZW PNONE <br /> C.ENEFIAL CONINACIOR MAK ADORESS <br /> SELECT HOMES, INC. 237 ELM ST EVERETT WA 96203 258-150ZIP 3E STATE LICENSEE - <br /> MECNAN,CALCONTRACTOfI MAK ADDRESS SELECHI110KN <br /> CITY IIP PNDNE <br /> STATE LLENSE E <br /> I'LUMBMO CDNTRACIOq MAA ADORESS <br /> GRY Ip PNO —.-- <br /> CONIgACT PgiCE OF WOp NE SIAIk LICENSE k <br /> 40000 ---- <br /> RE SCRIBE WORK AND SQUARE FDOTADE INOIVFD <br /> T'CW TACT 'ERSOY AND 17gNE NO <br /> SFR <br /> RANDY CLARK 258-1503 <br /> nRDPDSEDusEaBukowG I HEREBY CERTIFY THAT I HAVE READ AND EAAMINED THIS <br /> SFR APPLICATION AND KNOW (HE SAME TO BE TRUE AND CORRECT ALL <br /> LEDAL DF$CRIPTMNi DE PROPcgTY SWWN DELOW Oq ATTACN TVq COPN SI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> 3DE lIANABR00K DIy 3 NOT THEWORK FO GP OF AD ERMIWITH T+DOES ENOT PRESUME TOIGIO <br /> LOT--. &OCK VE <br /> �_ <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> O FHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTIOI I. THAT I AM AUTHORIZED BY THE <br /> OWNEP OF THIS PROPERTY TO Pi RFORM THE WORK FOP WHICH <br /> rARCEL TAA 10 NUMBER <br /> APPLICATION/I�IAS�y MADE AND I COMPLY WITH THE STATE <br /> f.ONSTPUCTgNLOAN(ENDER.ADDRESS,iFIEPNDNE NUMBER CIlNLT"` Rfi6gS, 7 T%AND 296200 WAC <br /> PROJECT ADDRESS ElX by : <br /> PLUMBING cur nusm ss lKlruro --- <br /> NO. TYPE OF FIXTURE OR ITEM MECHANICAL <br /> WATER CLOSE! .TOILET) FEE NO. TYPE OF EQUIPMENT <br /> BATHTUB --- <br /> NC—NHNDLG UNITS—Hp, <br /> FEE <br /> LAVATORY(WASHBASIN; FORCED AIR SYSTEMS—,.TU. M E.A. - <br /> SHOWER - - UNIT HEATERS—BTU. M , <br /> KITCHEN SINK 6 DISP CLOTHES DRYERS ' - <br /> _I DISHWASHER VENTILATION FAN —�- <br /> LAUNDRY TRAY RANGE HOOD <br /> CLOTHESWAS _WATER HEATER «-- <br /> URINAL — WOOD STOVE <br /> DRINKING FOUNTAIN METAL FIREPLACE.WOOD BURNING) <br /> FLOOR DRAIN FIREPLACE INSERT <br /> BACKFLOW PREVENTERS HEAT PUMP -----�— <br /> ROOF DRAINS—RAINLEADERS GAS PIPING <br /> SINK(SERVICE—BAR,ETC.. I EXHAUST FAN -----I--- <br /> , <br /> , <br /> I <br /> I <br /> SUBTOTAL f — <br /> PERMIT f SUB TOTAL f <br /> TOTALFEE f — PERMIT f <br /> FOR OFFICE_USE ONLY: TOTAL FEE f <br /> I gIM11 SE(BACK - , <br /> IY NI Sk(BACK SIDE SETBACK2e) PLAN C,ECK NU4 ER IEE <br /> IIyI <br /> _� l0 mg; VACANT SITE <br /> ES n NO FEES VALUA710N FEE <br /> IYNpCp61 NO.DP STOICS BVILDWG <br /> �f °RAwu�A,Y Kn u nwu.cwrL Q , <br /> SIA OFf' --- �-+�—✓ �'3 PLUMBING �— <br /> /677 Sf 7� TI41WYiNtI[IIS gEOD BASEMENT ; <br /> YES . <br /> DDCUPNNcr<woAF� O . NO ukcluNICAL <br /> TIRE NAPM REDO 79ZTT IMITATION ADDITIONAL PLAN CHECK <br /> REASON V `� OTHER <br /> IIIAKE B-y-- STATE BUILDING SURCHARGE <br /> JADBY CITY OF EVEflFTi — ' <br /> LOCAL SALES PD��WOPo`S <br /> DATE Z; y3 TAX CODE IS 3105 TOTAL ' <br />