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i <br /> APPLICATION FOR CONSTRUCTIGA PERMIT <br /> evcrett <br /> IINI Evnrgmnn <br /> CITY OF <br /> everett <br /> BUILDING DEPARTMENT TO BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> 1 DEMOLITION i I COMBINATION PC. BUILDING X)MECHANICAL x'PLUMBING i I SIGN <br /> OWNER MAIL ADDRESS CITY ZIP PHONE <br /> _SP1er_L_HQmeS.,., Tnc_ 237 PITILRt, Prerwth, WA 98203-1921 206-25R-1503 <br /> 1, TENANT MAIL ADDRESS CRY ZIP PHONE <br /> ARCHITECT OR DESIGNER MAIL ADDRESS CRY ZIP PHONE <br /> GENERAL CONTRACTOR MAR ADDRESS CITY ZIP PHONE LICENSE <br /> Select Homes, Inc. 237 ELn Street, Everett, WA 98203 206 258-1503 SELECHI10KN <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE, <br /> PLUMPING CONTRACTOR MAA ADDRESS CITY ZIP PHONE LICENSE, <br /> CLASS OF WORK <br /> NEW I I ADDITION 1 1 ALTERATION I I REPAIR Cl DEMOLITION I l WOODSTOVEIFRPL INSERT I I BUILDING RELOCATION <br /> TENANT IMPROVEMENT OR INTERIOR REMODEL ONLY CONTACT PERSON AND RHONE NO <br /> CONTRACT PRICE OF WORK: Randy Clark 348-1320 _ <br /> DESCRIBE WORK AND SOUAnE FOOTAGE INVOLVED <br /> inpuriptrilctirin SER I q 4 / <br /> PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> M <br /> i n APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LEM Ix nmTlTN or rnor. ry(SIOWN99FnATTACHFOURGWIFS) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LOT z BLOCK OF Hanabrook Div 1 WORK WILL. BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> 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 /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 FICIN AND 296.200 WAC. <br /> SIGNATURE OF CONTRACTORON AUTHORIZED AGENT DATE <br /> A <br /> F <br /> Select Ho s, Inc. <br /> D �F}R- s IL X <br /> PROJECTA ES9 '� <br /> ' CG AP••ICANi9 ITYD WE59 LK:EN9E 1q AND BUSINESS NAMF. <br /> PLUMBING �j MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENI FEE <br /> WATER CLOSET(TOILET) I AIC-AIHNDLG UNITS-H,13. <br /> BATHTUB I FORCED AIR SYSTEMS-B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) I UNIT HEATER&-B.T.U. M ; <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK A DISP 2 1 VENTILATION FAN ' <br /> I <br /> DISHWASHER I RANGE HOOD I <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER I WOOD STOVE i <br /> URINAL METAL FIREPLACE A CHIMNEY <br /> DRINKING FOUNTAIN , FIREPLACE INSERT i <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS i GAS PIPING ' <br /> ROOF DRAINS—RAINLEADERS , EXHAUST FAN —�— <br /> SINK(SE9VICE—BAR,ETC.) i <br /> , I <br /> , I <br /> I I <br /> SUB TOTAL f 1 SUB TOTAL f ' <br /> PERMIT f PERMIT f I <br /> TOTAL FEE f TOTAL FEE f ' <br /> FRONT SETBACK REAR SETBACK SIDE SETBACK PLAN CHEC/K j1 OEII FEEJ�� REC�� S <br /> 20 20 CP-7 <br /> USE ZONE LOT AnEA VACANT SITE FEES VALUATION FEE <br /> )tR YES ❑ NO Bu6oWG <br /> 1YPE Of CONST ALLOWABLE TYPE OF CONST ACTUAL IFTIPMC. N N MUM LVM I <br /> PLUMBING i <br /> I SIZE OF BLDG NO.OF`.TORIES BASEMENT MECHANICAL ' <br /> , <br /> ❑ YES O NO <br /> OCCUPANCY LOAD FIRE SPRNIAERS REO'D HEIGHT LIMITATION OTHER , <br /> YES I 1 VE.a 15t NO ISTATE BUILDING SURCHARGE <br /> REASON FOR SPRINKLERS <br /> STATE ENERGY SURCHARGE i <br /> APPLICATION ACC BY INNS APPROVED BY CITY OF EVERETT PUBLIC WORKS ; <br /> LOCAL SALES <br /> q Ib�j TAX CODE IS 3105 TOTAL <br /> i <br />