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____ _ _ ��-��, � <br /> m►i�P�MGAYI��I �Q� �O�STfRU�'� oON PE�MIT � <br /> TO BE COMPLETED iN BLACi< INK—PLEASE QRINT �%�J�� <br /> �� <br /> 1 BUILDING DEPP.RTMENT � HEATING SYSTEM: aJ GAS ❑ ELECTRIC ❑ <br /> 2S9-E3810 <br /> I I DEMOLITIaN I I COMBINATION 4�' BUILD!Dli; I � fV1ECH.qNICAL I I PLUMBING I I SIGN <br /> OWNER `,tAILADGdESS CITY 21P PHONE <br /> Dally i�omes, Inc. 3240 Gastlakr. Avenue East, /1200, Seattle, WA 98i0'G 328-3770 <br /> TENIINT \IAILFDDRESS CITV ZII' PHUNE <br /> ARCHITECTORDESIGNE(i MAI�ADORE55 LIT\' ZIP PHONE <br /> GENERAILONTRAGTOq MAIL4DDF[SS CITV 21P PNOKE STATELICENSEa <br /> Same zs above DALLYNI12017 <br /> MECNANICAICONTRACTOR MAILADUAE55 CITY ZIP PHONE STFTEUCENSEN <br /> PLUMOINGCONTRACTOq MAILAOORE55 CI7Y ZIP PHU4B STATELIGENS@R <br /> CLASS OF WORX ' � <br /> 17t1 NEW I I ADDITION I I ALTcF,ATION I I REPAIR I I DEMOUT!ON I I WOODSTOVElFRPL INSERT I I BUILDING RELOCATION <br /> f,ONT�GT PERSON AND VHONE NO <br /> CONiRACTPRICEOFWORK Ron Pe�rce 252-9098 <br /> OESCRI�E WORY,AHO SOU6RG F007AGE INVOLVEO <br /> .Tlm Schmidt 328-3770 <br /> P�aPO�POSEDUSEOF�IIIL/q,��N��,�� t, .�J�1r �+��,�} � I HEREB`� CERTIFY THAT ! HAVE READ F�.ND EXAMINED THIS <br /> S�r�r ;� L••�'u�I��J�� C:.1L� F��i-I IL� f-I(/P- APPLICATIOh AND KNOW THE SAME TO BF THUE AND CORRECT.ALL <br /> LEGALDESCNPTIONOFPROPEATV�SHGNN�ELCt40BATTAC FOURCOPIES� PROV�310N30rLAWSAN�ORDINANCESGOVERNING7HISTVPEOF <br /> WURK WILL bE GOMPLtiED WITH WHETHER SPECI�IED HEREIN OR <br /> tot BIQ;N _ OF NOT. THE GR;\N71NG OF A PERMIT DOES NOT PRES�IMF_ TO GIVE <br /> �UTHOR!TY TG V�OLATE 09 CANCEL THE PfiOVI510NS OF ANY <br /> — OTHER STATE OR LOCAL LAW REGULATING CCNSTRUCTION OR THE <br /> PEFFORM4NCE OP CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> l � � � _ OWNEfl UF THIS PROPFRTY TO PEP.FORAA THE WOf7K FOR WHICH <br /> APPLICATIVN IS tviAGE AND I COMPLY WITH THE STATE <br /> f,ONTRACTORSIAW 10.27 RCW AND 296.200 WAC. <br />� 1 �����'� �6� `�- <br /> vaaEcr,nopqr;,s, �{,;,�„ f' ^� - X,-�._���r <br /> ��v� �� , El_ .U, � �� <br /> �nv,i isr.•:s i n.i n;�r�n <br /> PLUM8ING fdEl'HANICAL <br /> N0. 7YPE OF FIXTURE O:i ITEh7 � FEE N0. TYPE OF EOUIPMENT FEE <br /> _ WATCR�LOSET(TOILET) _ _ � AiC�-NHNDLG UNITS-H.P. <br /> BATHTJ9 ; FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVAIORY(WASH BASIN) �- UNIT HEATERS-B.T.U. M <br /> SHONIER CLG�HES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILAi ION FAN <br /> OISHWASH[R � RANGF HOOD <br /> I_/�UiVDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER � WOODSTOVE <br /> URI�AL METAL FIREPLACE 8 CHIMNEY <br /> _ , DFiNK�NG'OUNTAIN FIREPLACE INSERT <br /> ��LOOR DRAI.ti HE�T PUMP <br />� BACKFLO�k PRE'JCNTERS G�5 PIPING <br /> _ ROOF DRAI�lS-RAINLEADERS CXHAUST FAN <br /> SINK(SERVICE--BAR,ETC.) <br /> - — -- � - <br /> -- � � <br /> — —r <br /> _ _ SUB TOTAL 5 SUB TOTAL $ � <br /> PERMIT $ PERMIT $ <br /> TOTAL FEE $ ' TOTA4 FEE $ <br /> FUR C�FFICE USE ONLY: <br /> FPONTSETB'�CAK BEAf1SET0ACN SIOESETBACN P�4NCNFCNNUM�ER FEE PEGEIPfNO. <br /> !�/ , � / c� / � L � � � <br /> osezor+e �ornne�n7�, VACANTSITE FEES VALUATION FEE <br /> � � �� " BUILDING � �';� ) <br /> iYPE Oi LONiS.ALLOWAOLi iVFE OF COHS�ACfURL O[tnnuKr NO Or p�v¢uuGuro�S <br /> '(��/ _ °p�`_°� PLU6IBING <br /> �Y.�.��L �� <br /> i <br /> --r— <br /> SVFOP9LDG. NO.OFSTOAIES BASEMENT �-- <br /> � $f {�Z,S'J MECH�NICAL <br /> S �'M�Abb O - <br /> OCCUPANCYIOAD FIRESPRNKLERSREO'U HEIGHTLIMITATION/ ADOITIONALPLANCHECK <br /> `' � Nu sr�v+Ht�r �'1 /O� <br /> REASOu FOR SPRINKLGf15 �- <br /> S7ATB BUIL�ING SUACHARGE �5 <br /> INTAKEBY P�ANSAPPROVED�Y CITY OF EVERETT PU�LIC WORKS �� � � <br /> LOCAL SALES ' <br /> TAX COUE IS 3105 TOTAL <br /> - - - — Ia !Z-�J1�1 L- — -- - - - - - � - <br />