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y,e <br /> F,►•va<_�c � -�:�*s x OR (: Q"3ST��4�' `i ilyTr�l PERMIT <br /> LCITY Fm�,n <br /> CITY OOF <br /> everett <br /> BUILDING DEPARTMENT <br /> H n 259.8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> yy DEMOLITION COMBINATION BUILDING x MECHANICAL x PLUMBING y <br /> HoMNrn n AGnnrss-____-_____ tnv im rHONE - — _ i <br /> H En _SP1£C-t._HO1MS.r Tnn_ �'i] T;lm Sf•F RVPYP}'} F W}�qA O�-_19.71G� fen�1 Cn <br /> Hj TENANT MAIL ADDRESS CITY <br /> ZP <br /> PHONE. <br /> < n <br /> ABCNnTF.CT d11R$MNCn MAR AIRINESS CITU Z,+ %K <br /> 0 = 0 1 <br /> It H rltl <br /> En H GENERAL CONTRACTOR MAR ADDRESS CITY Ilr <br /> .� PRgNT. LICENSE F <br /> 1-3 <br /> o Select Homea�Inc. 231 Elm Streetr Everett, WA 90203 206 250_1503 SELEC1111 ' <br /> F3 MECHANICAL CONMACMA MAR ADOIEBS CITY ZIP IMgN[— LICENSr 9— <br /> O <br /> H <br /> LTJ � PIUMBMO LONTnAf.TOR MAR ADDRESS CITY zip PIgN1E IILENSf 1 —_. <br /> H CIASS OFµORT( <br /> NEW I I ADDITION 1 ALTERATION ! I REPAIR f 1 DEMOLITION I I WODDSTOVE?RPL INSERT BUILDING S1 I <br /> yz I-1 <br /> t" Hy <br /> LA CONTOVACT INRCE oTµDir;IT NATO PAPFROV urw on MT ROD REMODEL ONLY CO/TAC T PERSON ANSI PNONE Nn <br /> g C ti Randv Clarks 348=1320 <br /> Q DFCRNIE WORK AND 50UAliF FO01ApE TIVOLKD <br /> L71 <br /> LTy" m 1:oaa <br /> rnurDn ra or lDH [n m >T L <br /> I HEREBY CERTIFY THAT I HAVE READ AND F.XAMETU r <br /> _&]n le _£ami 1 v rngj�in APPLICATION AND KNOW THE SAME TO BE TRUE AND Cnin <br /> LEO De.tlTrrKxl ar P� OI'AYN avow AT Ac Faun coP�E,1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING I III <br /> LOT. � DOr,K o. �jg�abS9ak n�V 1 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED II <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUML 1 <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS 1!1 <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION nl} <br /> PEAFORMANCE OF CONSTRUCTION.THAT I AM AUTHOnin P I, <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK F-OII V <br /> APPLICATION IS MADE AND I COMPLY WITH THF <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SIGNA41 �nmm <br /> ON ACTORDIAUT4DOZEDAGENT DATE <br /> XSmes, Inc. <br /> PROJECT ADDRESS / z <br /> 13� LDS I C dA MECS LICE 5E AIm BIISMESS NAME. <br /> PLUMBINGR <br /> F __ MECHANICAL <br /> I C NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FLI <br /> WATER CLOSET(TOILET) f' _ _ A/C-A1HNDLG UNITS-H.P. <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> 1 LAVATORY(WASH BASIN) 1�T UNIT HEATERS-BTU. M <br /> A's Z SHOWER CLOTHES DRYERS <br /> !a� <br /> KITCHEN SINK A DISP S"'i - 2 VENTILATION FAN <br /> _DISHWASHER 1 - I RANGE HOOD - <br /> I LAUNDRY TRAY --- <br /> � , WATER HEATER <br /> _l- CLOTHES WASHER , WOOD STOVE <br /> 1 URINAL METAL FIREPLACE A CHIMNEY <br /> DRINKING FOUNTAIN , FIREPLACE INSERT <br /> FLOOR DRAIN I HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> .1'J1 ROOF DRAINS-RAINLEADERS I EXHAUST FAN <br /> SINK(SERVICE-BAR,ETC.) <br /> I -- <br /> SUB TOTAL f - SUBTOTAL f �c - <br /> �,� PERMIT f I PERMIT <br /> TOTOTALFEE f <br /> FnONI SETBACK BEAR SETBACK SIDE SETBACK n AN CHECK NIIMBFR FFE BFrnr, <br /> 20 20 5' 7 Sr>-o 1 3tVALUATIGN <br /> ASC-0 <br /> USE ZONE LOT AREA VACANT SITE FEES FEE <br /> 1tR YF.S I I NO BUDDING <br /> TYPE OF COST.ALIOWARE TYR D CRRST VIAL ITT,HIAY bnAR1,1F,M,5 �_. S <br /> ✓- ,V d'. / PLUMBING <br /> sIlC OF DOO w NO a STOnE"i BASfuENI <br /> �7 f�S'f r Sl I I YES •PI NO MECHANICAI. q,d as <br /> OCWPANCYLMD FTRF BRAWLERS REDO TEIONTL ITATRIN OTHER <br /> vt/1A YES X NO / <br /> REASONFORBPRINIR[R9 STATE BUILDING SURCHARGE — <br /> � „rU <br /> _ STPI ZNERGY SURCHARGE <br /> AMCAIKINACC BY PIANSAPPROVEOBY CITY DF EYERETT PUBLIC WORKS ' <br /> L01:AL SALES d �` <br /> yr. TAX CODE IS 3105 TOTAL <br />