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�►PPLICATIC -'! FOR CONSTRUC'3 )�1 PERIVi1T �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRIN7 ET'=nE'T <br /> 94 R 547 — -- , <br /> HEATWG SYSTEM: XJ GAS J ELECTRIC J I <br /> DUILDING DEPARTMENT - ' <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING X MECHANICAL PLUMBING SIGN <br /> owr+eF i.�nanooness cirr na allor;e <br /> Dally Homes 3420 Eastlake Ave I: 11200 Seattle ldA 98102 328-3770 <br /> �eu,wr r.enano�aess cirv zir rHove <br /> AFCMITECTOfiDESIGNER MAILApDRE55 CRY ZIP PHONE <br /> GENERALCONTRACTOP IdAIL��ORE55 CITV ZiP PHOYE STAIELICENSh. <br />� Horizon Heating, Inc 3601-121st ST SW Lyn�ood IdA 98037 745-3930 HORIZHI137DU <br /> MECH�NICALCONTRACTOR MFILADDRESS GITY ZIP PHONE STATELICENSEx <br /> PLUTABINGCONTRACTOR MNL��ORE55 CRV 21P PHONE STATEIIGLNSEa <br /> CONTPFCT PRIGE OF WORN <br /> $4245.00 <br /> °T��"Qa�.`�'"�"�YS$a�c�e;o`�io��"wa�er tank & gas piping CO�Ts�e�`�°Nfa�'�re�og ;'�5-3930 <br />� . i HEREBY CERTIF`! THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSE�USE OF BUILDING qPPLICATION AND KNOVJ THE SAME TO BE TRUE A�D CORRECT. AL'_ , <br /> PROVISIONS OF LAWS AND ORDINANCcS GOVERNING THIS TYf'C Oi- <br /> �ecn�oescaianoNocaaoaEaTv�sHowNae�owoanrrnci+rwocoaiesr WORK WILL 8E COMFLETED WITH WHETHER SPECIFIED HEREIN OR <br /> 44 The PYeserve NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 70 G!vE <br /> �ot e�a:K nF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF APJY <br /> OTHER STATE OR LOCAI LAW REGULITING CONSTRUCTION OR THE <br /> PERFORA1ANCE OF COPISTRUCTION. THAT I AM AUTHOFIZED BY THF <br /> OWNER OF THIS PROPERTY TO FERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PAflCELTA%ID.NUMBER CONTRACTORS i pW 1827 RCW AND 296.200 WAC. <br /> C01�STRUCTIONLOANLEN�ER.ADDRESS,TELEPHONENWABF_!i J � � � L^�—C�1 I <br /> , � _ l./�/4 . T U <br /> pP. ECT ADDRESS . r ��R�F <br /> 6��-40th Place �:�r.����s�::�ss��,:��:;�:,� _ <br /> PLUMBING MECHANICAL <br /> . NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EDUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—A�HNDLG UNITS—H.P. <br /> BATHTUB 1 FORCEDAIRSYSTEMS—B.T.U. M E.A. ���~ -� <br /> LAVATORY (WASH BASIN) UNIT HEATERS—B.T.U. M __ <br /> SHOWER CLOTHES DRYERS _ <br /> I(ITCHEN SINK&DISP ; VENTILATION FAN _ <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ; 1 WATER HEATER ' � ' _ <br /> CLOTHES WASHER WOOD STOVE _ <br /> URINAL METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' _ <br /> BACKFLOW PREVENTERS 3 GAS PIPING � � � � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR. ETC.) <br /> � ' <br /> � <br /> SUB TOTAL $ SUB TOTAL S S� ;00 <br /> PERMIT 5 PERMIT S 15 �00 �. <br /> TOTALFEE S TOTALfEE S g5 '00 <br /> FOR OFFI�E USE ONLY: <br /> FPONTSET84GK FEAFSETBACK SIDESETBACK PLANCHECKNUI.I�ER�i FEE RECEIPTNO. <br /> � � <br /> 4�� <br /> usezor�e LOTAREA V�CANTSITE FEES VALUATIOM FEE <br /> '-� YES �-1 NO gUiLOiNG ' <br /> IVr'C Of C�HSi N0.OP STORIES OCLui'.!IP' �:0 Ot p>lFLLihG llhil5 -- I <br /> cnauv PLUMBWG � <br /> 9ZE OF�LDG. FIPE SPRINKLERS REO'D BASEMENT MECHANICAL I <br /> _—�. YES � . NO i <br /> OCCUPaNCY LOAD FIFE ALARM REO-D HEIGHT U�dITATION ADDITIONAL PLAN CHECK <br /> OTHER <br /> iL�S�N <br /> STATE BUILDING SURCHAFGE <br /> r,�r,;re ev r�nrvs naPaoveo ov CITY OF EVERETT PUBLIC WORKS <br /> LOCAL SALES <br /> ,,,,,, TAX CODE IS 3105 TOTA� <br /> n� <br /> yyjj�� _ �^, '�A "^�r�,-„+ <br /> ,� _ �'�"��+"''„�..�-W,..,� r�&! <br /> p •� �.. _'_Y . . . . . . � . J <br /> a q��. • <br /> � <br /> �._. ..,.. ��SeAMPfY.� n::i. �tM1`Kwi�t[4`�/W-„4 , :'�� 1.� ....., yE . .....�.. .. ...:. .�. ":� -� �� +q.'S"'�'KMY <br /> r. . . .. Y, �- . . . � '. �- . - _ � ' . . <br /> . . .. . .. . .. ' ' ' . ' " . �uR� <br /> � � <br /> � <br /> � .�. . - .. . ". h... ..✓e.. <br /> . .... K•b'- . .��— . . iyT.: L.... <br /> ' . . . ' _ .... �. • <br /> � _ . _' ty - q.L'�...��' <br />