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APPLICAT► JN FOR CONSTRUC _ ION PEnmIT <br /> TO BE C [ED IN BLACK INK—PLEASE PRINT <br /> (BASIC P N: MAPLE (CITY NO. 10`7 ) <br /> BUILDING DEPARTMENT ---[L-HEATING SYSTEM: a_GAS ❑ELECTRIC ❑ 1 <br /> 259.8810 — 1 <br /> I DEMOLITION pp COMBINATION LJ BUILDING U MECHANICAL PLUMBING I I SIGN <br /> OWNER MAILADDRESS CITY ZIP PHONE <br /> SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 <br /> IENANI MAIL ADOHES5 CITY IW PIgNE -- <br /> AIILNIiEC1011 DCSICJILR MAI ADDRESS CITY IIP PIKNe <br /> GENERAL CON1RACTOR MAIL ADDRESS C11Y IIP PICVIE S1AiE IM:CN,iE I <br /> SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 SELECHI110KN <br /> Mf CKMICALCONTRACTOR MAILADCAESs CITY IIP PNDNE <br /> SIATE IICE'NSF F <br /> PLIMBINO LONTRACIOR MAI ADDRESS CITY ZIP p,pgE --_ <br /> S1AII IICENSE F <br /> CONIRACT PRICE OF WORK — <br /> 40000 <br /> DESCRIBE WORK AND SOIIARE lOO7AGE INVOKED CONTACT PERSON AND 1'IIONE NO <br /> SFR _ Randy Clark 258-1503 <br /> rnoPEsiDustDFDERUKDwr. — I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME'0 BE TRUE AND CORREG f. ALL <br /> PRCVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL�RIPTION OF PROPERTY ISHOWN BELOW OR ARACH TWO COPIES) WORK WILL BE COMPLETED WITH FFHETHER SPECIFIED HEREIN OR <br /> LoT I`T BLOCK OF —LIENS@ROOK DIV 3 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCEL TAXI DNUMBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> NTRACTO�g`Ayy 18.27 A! �296.200 WAC. <br /> A [ONSTflMTIONLOANLENDER,ADDRESS.TElEP110NENUYBER SQEL11A HOMES, INC. <br /> PROJECT AD <br /> I'D"Ar� NIF <br /> crtr eusl+ss lKrHv Ha <br /> PLUMBING M. CHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPME V7 <br /> 3 WATER CLOSET(TOILET) FEE <br /> 2 BATHTUB A C—A HNOLG UNITS—H.P. <br /> 3 LAVATORY(WASH BASIN) I FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> 1 SHOWER UNIT HEATERS—B.T.U. M <br /> CLOTHES DRYERS <br /> l KITCHEN SINK 8 DIDRYERS VENTILATION FAN <br /> _ 1 DISHWASHER 1 RANGE HOOD —i--- <br /> LAUNDRYTRAY ' 1 WATER HEATER <br /> I CLOTHES WASHER WOOD STOVE --1" <br /> URINAL , <br /> METAL FIREPLACE(WOOD BURNING) �— <br /> DRINKING fOUN7AIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR.ETC.) <br /> ; <br /> I - ' <br /> SUB TOTAL $ ; SUB TOTAL S , <br /> PERMIT $ __ PERMIT $ <br /> ' <br /> TOTAL FEE $ TOTAL FEE S , <br /> FOR OFFICE USE ONLY: <br /> II«»i�sEI�E1CN I1CAn BE1BACIL ypE� y <br /> 7V�- PWICHECKNMBER FEE IK a mi NO <br /> i,/a 3 0 3 u <br /> 'I �1 lOT AREAVACA'.I SITE <br /> rYES p L10 FEES VALUATION FEE17H fX CONS( ND FIUILDING �7EOl sidl(S PLUMBING7 OF OL FOIE SPRPi4ERSIV.Ip.S T ' <br /> „� MECHANICAL , <br /> L' LI YES IVE PIO , <br /> I OCCUPANCY LOAD FIRE ALARM PcOD NEKINILMITATIM ADDITIONAL PLAN CHECK ' <br /> N <br /> IIAS(W OTHER <br /> STATE BUILDING SURCFLMIGE <br /> IN1AKE er PIATLS NN'�OVk,.Hti CITY OFEVERETT PueLK;woRKs <br /> J� LOCAL SALES ( ; <br /> OAIE 2? y TAX CODE IS 3105 707A► <br />