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�-----�------ ^_ _-�______ �_� <br />� APPLiC/.�'i'1�,.� FOR C�I�9STRUC7 oON P�RMI'C � <br /> TO BE COMPLETED IN BLACK Ii�K—PLEASE PRINT �C� <br /> j'�U`�IC �-i �� (�, ' <br /> BUILDING DEPARTMENT HEATING SYSTEM: (,�GAS 0 ELECTRIC ❑ � <br /> 259-8810 <br /> I I DEMOLITION I I �OMBINATIO� IX BUILQ'':G I I MECHANICAL I I PLUMBING I I SIGN <br /> OWNEF MAllA00RE55 CITY ZIP PNONE ' <br /> Dally Homes, Inc. 3240 Eastiake Ave. Fast Seattle, WA 98102 328-3770 <br /> TEN�NT MAI�ADORE55 CITV ZIP PHONE <br /> ARCHRECTORDESIGNER MFILAD�RESS • CITV ZIP PHONE <br /> GENEBA�CONTRpCTOH MAILADDAE55 CITY ZIP CNONE 5T4TELICENSE� � <br /> Same as lbove DALLYHI120i7 <br /> MECNANICRL CONTR4CTOR RINL ADORESS p�TY ZIP PHONE STATE UCENSE N <br /> PLUMBINGCONTRACTOR MAI�ADDRE55 CITY ZIP PHONE STATELICENSLO <br /> CLASSOG WORK — <br />' I X NEW I I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I Vy00DSTOVE;FRPL INSERT I I BUILDING REIOCP'ION <br /> CONT�CT PFfi50N AND PHON[NO <br /> CONTRAC:PPICEOF WORN RO❑ Pearce 252-9098 <br /> DESLRIBE WOR�J A1 DS�AFE FOOTr1GE INVOIVED <br /> � ��C�� 't-' Sherry Hunter 3?8-3770 <br /> PFOPOSEDl15EOF[1WLDING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Single family home APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFiECT.ALL <br /> LEGAL DE�S2CRI TION OF PROPERTY�SHOWN DELOW ORAr'JJ�/��J,+��F�ou/g�2}�,,PIES� PROVISICNS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �or -?-� e�xK oc �e'7"u'�- //LC.'�Cf� G�� NOT THE`GRA T NG OF A ERMIT,DO SENOT PRIES�MEETOIGIOVE <br /> � y� � '/ - AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OI� ANY <br /> �YC�� ��/ � OTHER STATE OR LOCAL lAW qEGULATING CONSTRUCTION ON THG <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUl HORIZED BV THF <br /> OWNER OF THIS PROPERTY TO PERFnRM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CqMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> i <br /> X ��� ���;�;�� �,>�r��%t �,1� � ;���, <br /> PROJECTADDRES )��' y//� n smrvn�we / ^i <br /> �r�l /' l�L�� r.nvnus�r mu�'.ni:tr�o � � — . <br /> PLUMBING MECHANICAL ' <br /> �l0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br />� � WATER CLOSET(TOIIET) � A/C—NHNDLG UNITS—H.P. � <br /> BATHTUB � FORCED AIR SYSTEMS—B.T.U. M E.A. �i <br />� _ LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ' <br /> SFIOWER CLOTHES DAYERS <br />, KITCHEN SINK 8 D!SP ; VENTILATION FAN <br />� " � D�SHWASHEfi RANGE HO00 <br />� LHUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL � METAL FIREPLACE 8 CHIMNE� —~ <br /> OFINKING FOUNTAIN ; FIREPLACE INSERT ' I <br /> , <br /> FLOOR DRAIN � HEA?PUMP �— I <br /> � BACKFLOW PREVENTERS GAS PIPING I <br /> ROOF DRAINS—RAINLEAD[RS i EXHAUST F�N � <br /> SINK(SERVICE—BAF,ETC.) � <br /> _ � � <br /> -- <br /> ' �--- <br /> SUB TOTAL $ SUB TOTAL $ <br /> PERMIT $ PERMIT $ <br /> _ TOTAL FEE $ ; TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETOP.GN REAFSETOAGK SIDESETBACK PLANCHFCHNUM�ER fEE RECEIPiNO. I, <br /> � o' GP� �' � yo�� 3c- �l��S�� <br /> us[zJo�r+e �ornnen VACANTSITE FEES VALUATION FEE <br /> /�' `�� �` `�`r BUILOIN4 �j/f C'�� J��- %�1 <br /> TYPEOFCONIS.ALIOWABLE NPEOfCONSI.FCTUAt occur�Ntr NaarvxtluuGUHns '(� , <br /> —N � � °,3 PLUM0IN� �;� <br /> SICEOFBIDG NOAFSTORIES OAC°MENT MECHANICAL --�— <br /> ��Zos�tcart 2 <br /> < <br /> OCCUP�NCYLOAO FIRESPRNNIERSREO'D HEIGHT!IMITAiIDN J ADOITIONALPLANCHECK � <br /> � � � � � <br /> REASONFOpSPRINKLERS � SPAI LEfl � ;,I�SY� � � U�.�� <br /> STA7E�UILDMG SUFCHARGE � - �� <br /> :� �� �, <br /> INTAKEBV PLANSAt;PPQVEDBY CITYOFEVERETT PUBLICWORNS '�� ���� , <br /> Jn LOCALSALES <br /> 5 6 9 TAX COOE IS 3105 rora� i_ �pC� ' S� <br /> .,�'" <br /> `��--L- <br />,,... -"'��T-.�.- ... . _ .- Q, „� 3 <br /> . . _...,. � . .���_-."' b a-r*� <br />