Laserfiche WebLink
APPLICATIO1. FOR CONISTRUCT& PERMIT <br /> IhP Everg.reI, I'\1•n I <br /> CITY <br /> BUILDING DEPARTMENT <br /> 1 259-8810 TO BE COMPLETED IN INK—PLEASI. PRINT <br /> I I DEMOLITION I COMBINATION X BUILDING X MECHANICAL PLUMBIVCi SII. <br /> OWNER - MAIL ADDRESS — CITY 21P — - P IC IN( - <br /> TENANT MAIL ADDRESS CITU 21P PHONE <br /> ARCHITICI OR DESIGNER MAK ADDRESS CITY 21P -PHM <br /> --- <br /> GENERAL CONTRACTOR MAB ADDRESS CRY 11P PHOI;E LICENSE <br /> ' Select Homes, Inc. 237 El.m Street, Everett, WA 98203 206 25_8-1503 SELECHIlOn <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY 21P PHONE LICENSE/ <br /> M IIMDINGCONIRACTOn MAB ADDRESS CITY 21P PHONE LICENSE/ <br /> CLASS OF WORK <br /> Nk EW I 1 ADDITION I I ALTERATION I I REPAIR 11 DEMOLITION I WOODSTOVE/FRPL INSERT ! BUILDING RELOCAI R n <br /> TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY CONTACT PERSON AND PV:)NE NO <br /> CONTRACT PRICPOFWORK. Randy Clark, 348-1320—zS8/.�v3 <br /> UESCRInr WORK ANI)SOIJADF rDOTAOE INV[KVED ' <br /> S <br /> t PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COHPLr T <br /> LEGAL DESCRIPTION OF PROPERTY(SHOWN RELOW OR ATTACH FOUR COPIESI PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TY? <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEPI <br /> LOT 1— BLOCK OF Hambrook Div NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME I <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS I ! <br /> OTHER STATE OR LOCAL IAW REGULATING CONSTRUCTION UI <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY 1 <br /> OWNER OF THIS PROPERTY TO PERFORM THE WCRK FOR WHI <br /> - APPLICATION IS MADE AND 1 COMPLY WITH THE STAI <br /> CONTRACTORS LAW 18.27 RCW AND 298 200 WAC. <br /> SIGNATURE Or CFR,TRACTOR On AUTN)RRED AGENT DATE <br /> / Select H mes, Inc. <br /> PROJECT ADDRESS _ <br /> RtIY1.!ANfs piv ppSINF55 LKJFNSE HO AND BUSINF.BB NAMF. <br /> PLUMBING MECHANICAL _ 2 <br /> NO. TYPE OF FIXTURE OR ITEM FEE FIG, TYPE OF EQUIPMENT FEE p <br /> WATER CLOSET(TOILET( As I- AIC-AN'ATLi3 UNITS-H P. <br /> Z BATHTUB O ' - FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> 31 LAVATORY(WASH BASIN( I UNIFREATERS-B.T.U. M <br /> -- f <br /> SHOWER ' CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP i VENTILATION FAN <br /> DISHWASHER ' RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER I WOOD STOVE <br /> URINAL ' AIETAL FIREPLACE b CHIMNEY ..0 0Z) <br /> DRINKING FOUNTAIN I FIREPLACE INSERT <br /> FLOOR DRAIN ' HEAT PUMP 1 <br /> BACKFLOW PREVENTERS i GAS PIPING <br /> R90F DRAINS-RAINLEADERS I EXHAUST FAN - <br /> SINK(SERVICE-BAR.ETC.) ' <br /> — <br /> I <br /> I <br /> I <br /> I <br /> SUB TOTAL $ - SUB TOTAL 5 <br /> _ PERMIT PERMIT $ <br /> TOTAL FEE S (vU " TOTAL FEE E <br /> FRONT ST TRACK FEAR SF TRACK SIDE SETBACK PLANCHECK NNMnEnrEE 011.1.111.11 <br /> 20 20 t;9 leo / `�-30 $ '?5 <br /> USE?ONE LOT AnEA VACANT SITE FEES VALUATION FEE <br /> IA01 <br /> " �j g5;50 <br /> RPT OCDNSAT ALADWPE dABIE 1YCONST ACTUAL BCIAAYMY XX s r11 O❑ o BUILDING <br /> FJ NN UPR <br /> PLUMBING <br /> 511757 SF} In a SILSn11s BASEMENT MECHANICAL Ov <br /> Siy JO Gilt Z I I VES NO -- —7 <br /> OCCUPANCY OAO FIRE SPI Tn5 nra0 NEIOIIi LIMITATIOII OTHER / <br /> ' VES ')( NO ZS I STATE BUILDING SURCHARGE �y •SO ILM <br /> nfA!K1N rOn FPR.NKLFR9 — p1 <br /> STATE ENERGY SURCHARGE <br /> APPI ICAIK)N ACC BY PLANS APPROVED BY CITY OF EVERETT PUBLIC WORKS d0 QV <br /> LOCAL SALES <br /> `7 TAX CODE IS 3105 TOTAL <br />