3 59TH PL SW 2016-01-01 MF Import

NPPLICATI 'N FOR COmSTR u%. iuN PERMI't, TO BE COMPLETED IN BLACK INK—PLEASE PRINT �n*1tcTT BASIC PLANIMAPLE. (CITY NO. 101 ) BUILDING DEPARTMENT HEATING SYSTEM: &GAS UELECTRIC 259-8810 DEMOLITION D9 COMBINATION ❑ BUILDING ❑MECHANICAL I PLUMBINrA I SIGN OWNER MAIL ADDRESS CITY ZIP PHONE SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 IINANT MAIL ADDRESS CITY IF PIKNIE ARCHIIECT OR OLSIGNI II MAA ADDRESS CITY TIP PIKP1E ---- --- --_ 1 GENERAL CONTRACTOR MAIL ADDRESS CITY N PWNE STAIL LICENSEI SELECT HOMES, INC. 237 ELM ST EVERETT 98203 258-1503 SELECHI110KN MI CHANK:AL CONTRACIGH MAA ADDRESS CITY 1. PIKINF SIAIF IKA NSF I PLUMBINOCONTRACIOR MAIL ADDRESS CITY SIP PHONE STALL LICENSE ViNTRACI PRICE OF W WK 40000 DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED CONTACT PERSON AND PHONE NO FR Randy Clark 258-1503 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL SPR PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF LLGAL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH TWO COPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR LOT -- BLOCK OF nANABROOK DIV 3 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY --- OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE )� W OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE _PARCEL TAIL I D NV CONTRACTORS 18.27 RCIALAND 296.200 WAC. l lN1SIRUCTKXI LOAN LENDER.ADDRESS,TELEPHONE NUMBER .SELECT H S IN(: PROJIT ADDRESS �� 5 , 1 wKArw SAIL --_ tft ((/ ClTr eusu ssl Kl KV Hn PLUMBING MECHANICAL NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE 3 WATER CLOSET (TOILET) A.;-A/HNOLG UNITS-H.P. 4-1 BATHTUB j FORCED AIR SYSTEMS-B.T.U. M E.A. —~- 3 LAVATORY(WASH BASIN) UNIT HEATERS--B.T.U. M SHOWER j CLOTHES DRYERS -� j KITCHEN SINK 8 DISP VENTILATION FAN _ j DISHWASHER ]. RANGE HOOD LAUNDRY TRAY j WATER HEATER -� j CLOTHESWASHER WOOD STOVE _ URINAL METAL FIREPLACE(WOOD BURNING) —�— DRINKING FOUNTAIN _ FIREPLACE INSERT ; FLOOR DRAIN HEAT PUMP , BACKFLOW PREVENTERS '1._ GAS PIPING ROOF DRAINS-RAINLEADERS 2- EXHAUSTFAN , SINK(SERVICE-BAR,ETC.) I , I - 11 I I -_ SUB TOTAL f SUB TOTAL f ZYJ PERMIT f _ PERMIT f TOTALFEE f TOTAL FEE f FOR OFFICE USE ONLY: INUNISl 1 TBACN RLARS60,%CK SIDE SETBACK PLANCHECKNUMBER Ill RLC zol__ Rr 51 Tc Mw - 1 t I I — USE AWL t Ia" VACAN SME FEES VALUATION FEE -7 R-z _ __ I+fYES ❑ NO BUILDING 6 S 9 IRTIVGWSI - STORIES PLUMBING V[OF DL1C IINL SfgWKLLRSHE00 BASEVENT —� )52 S L AR O 11 YES 1��0 MECHANICAL IDD; UCCUPANCY OAD FINE ALARM REOD HEIGHT LIMIIATIDN ADDITIONAL PLAN CHECK vo f� I REASON STATE BUILDING SURCHARGE INTAKE BY PLANSAPf EDBI CITY OF EVERETT PUBLIC WORKS 2 ) �// LOCAL SALES uAIE S 28 9 5 TAX CODE IS 3105 TOTAL i/;