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fA18NIPEP/W1 <br />CITY OF <br />everett <br />259-8745 <br />C INSTRUCTION <br />PERMIT <br />PERMIT NQ. - <br />16837 <br />DEMOLITION ❑ COMBINATION ❑ BUILDING G MECHANICAL [-I PLUMBING ❑ BIG" <br />DI M[A MAIL ADDRESS CITY ZIP PHONE <br />Greg Norris 3030 Rucker Everett, WA 98201 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PRONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP h•DNE LICENSER <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ZI DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />I <br />DESCRIBE WORK <br />Demolition <br />HEAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />garage <br />I HERcBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORNECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR L CAL LAW REGULATING CONSTRUCTION OR <br />THE P F CE OF CONSTRUCTION. <br />SIG TRA RIjjbEM . AUTHORpJT: OR OWNER DATE <br />\ 7/16/86 <br />LEGAL DESCRIPTION OF PROPERTY (SNOW BELOW OR ATTACH FOUR COPIESI <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />3021 Grand Ave <br />PLUMBING <br />MEC NI L <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — A/HNDLG UNITS — H P. <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA. <br />LAVATORY (WASH BASIN) <br />BOILERS — B.T U M.P. <br />SHOWER <br />GAS FIRED A.C. UNITS — B.T U. <br />KITCHEN SINK & DISP. <br />FORCED AIR SYSTEMS — B 7.U. M EA. <br />DIaHWASHER <br />WALL HEATERS —BTU. M <br />LAUNDRY TRAY <br />UNIT HEATERS — BT.U. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />_ <br />URINAL <br />CLOTr1ES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK ISERVICE — BAR. ETC) <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />S <br />SUB TOTAL. <br />PERMIT <br />f <br />PERMIT f <br />TOTALFEE <br />f <br />TOTAL FEE <br />WONT SETBACK <br />REAR SETBACK SIDE <br />SETBACK <br />PLAN CHECK NUMBER <br />FEF <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA vACANT <br />SITE <br />❑ YES ❑ NO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />-0- <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELL ING UNITS <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />MAX OCC LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REQUIRED CIYES ONO <br />INVESTIGATION FEE <br />Sec. 904(e) <br />STATE BUILDING SURCHARGE <br />1 <br />50 <br />STATE ENERGY SURCHARGE <br />07/16/86 3= <br />00W1 1 <br />APPLICATION ACC BY <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />N0001607 <br />TOTAL <br />1 <br />50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED IN TUFMCE) THISUVOUR PERMIT E_ <br />M <br />co <br />CD <br />T_ <br />ADDRESS FILE <br />