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APPLICATICA FOR CONSTRUC7�bN PERMIT <br /> IT <br /> everett <br /> INT ErTNpleun <br /> CITY Or <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> DEMOLITION I I COMBINATION A BUILDING $I MECHANICAL Ix,PLUMBING I I SIGN <br /> • DYYHEq MAIL ADDRESS CITY ZIP PHONE <br /> i sEA1EA t NnmaaF Tnc• 217 Elm 9t Empratt, WA 7n -1991 2n6-2SR-1503 <br /> ? 0 H I TENANT MAIL ADDRESS CITY ZIP PHONE <br /> [[[iiiTTT444777 <br /> 1 ARCATECTORIIESIGNER WA ADDRESS CITY ZIP PHONE <br /> 10 <br /> e,3 E4 N:•NEau cDNlrutom WK ADDRESS CITY ZIP PHONE LICENSE <br /> Select Homes Inc 237 Elm Street, Everett, WA 98203 206 258-1503 SELECHIIOKN <br /> - MECIMNICALCONTRACIOI MAB ADDRESS CITY ZIP PHONE LICENSE, <br /> H XI <br /> PLUMBING CONIRACTOII MAIL ADDRESS CITY ZIP PHONE LILENSEF <br /> N <br /> z• I•f5 CLASS OF WORK <br /> 0O Ei�7 �XNEW i I ADDITION 1 I ALTERATION 1 I REPAIR EJ DEMOLITION I I WOODSTOVE/FRPL INSERT Ll BUILDING RELOCATION <br /> C•7 T ENANT IMPROVEMEN I ON INTERIOR REMODEL ONLY CONTAC I PERSON AND PHONE NO. 7 <br /> CONTRACT PRICE OF LYOFK: Rand Clark 348-1320 <br /> DEKINSE INO K AND SQUARE FOOTAGE INVOLVED <br /> 'y Iti <br /> � ^^..nstruction SP8 <br /> PRorrosfoUSE OF Ruu.DIND I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> H APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> r'y �L <br /> ❑N L[�GAL�OC RIPIpN GE PIKN'ERTY�SeKMSIN�BELOW ORearACN Fcuq cGPlEsI PROVISIONS OF LAWS AND ORLINANCES GOVERNING THIS TYPE OF <br /> LOT WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �+ '�Dc" a NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> M AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> 13 y0 y 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 /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SKWATUREOFCONTM TOIORAUTHDRIZEDAGFNT DATE <br /> n Be� lle tt Ines, Inc. <br /> T '►[ <br /> i PROJECT ADDRESS v C <br /> NTS CI BSINESSIICENSE NO ANOSUSINE59 NAMf <br /> PLUMBING JC MECHANICAL <br /> I <br /> NO. TYPE OF FIXfURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> w '3 WATER CLOSET(TOILET) I - A/C-NHNDLG UNITS-H.P. <br /> Z- BATHTUB ' FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> 13 LAVATORY(WASH BASIN) - UNIT HEATERS-B.T.U. M ' <br /> uF SHOWER I CLOTHES DRYERS <br /> KITCHEN SINK It DISP ) - VENTILATION FAN _ <br /> r DISHWASHER '" RANGE HOOD T— <br /> _ LAUNDRY TRAY _ ; WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> 1 ' 4 URINAL ' METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT I <br /> _ FLOOR DRAIN ' HEAT PUMP <br /> _ BACKFLOW PREVENTERS i OAS PIPING , <br /> 1 ROOF DRAINS-RAINLEADERS I EXHAUST FAN I <br /> SINK(SERVICE-BAR,ETC.) <br /> I I op <br /> _ I I <br /> i i I <br /> I <br /> SUBTOTAL S ;- SUBTOTAL f ' I" <br /> PERMIT f I PERMIT f r <br /> TOTAL FEE f &C.) ' - TOTAL FEE f ' CO <br /> MINI%IIFIA.K OEM SE TBACK SIDE SETBACK PLAN CHECK NUMBER FEE RECEIPTNO <br /> 20 20 77 30 5314 <br /> USE ZONE Lot AREA VACANT SITE FEES VALUATION FEE <br /> XXYES I I NO BUILDING <br /> TY dCplSlNlONABIE TYPE OfLUNSIKIM 014T I waimummis — TbIr665 _. ?95'5 <br /> 'AJ —Aj PLUMBING _ <br /> a `GOLDNO O STORIES BASEMENT MECHANICAL ' <br /> I.Sig 7 D 'GA 2 I I YES If NO <br /> OCCUPANCYIOAD TIRE M-11WIERSREOD IIEgHRM1TATKW OTHER <br /> !I YES X NO STATE BUILDING SURCHARGE <br /> REASONFOISPRINKLERS <br /> STATE ENERGY SURCHARGE i <br /> APRICATIONACC BN q�INANSAPPROVEDBY CITY OF EVERETT PUBLIC WORKS LOCAL SALES <br /> N/3 TAX CODE IS 3105 TOTAL p 7cl:ob <br /> f , F <br />