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the EE.'CCITY OF <br />'ONSTRUCTION�� <br />'� <br />everett <br />259-8810 <br />PERMIT PERMIT <br />NO. _ 22168 <br />6 DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL <br />❑ PLUMBING <br />❑ SIGN <br />OWNER <br />Gary I. Harstad <br />MAIL ADDRESS CITY ZIP <br />2820 86th St. SE Everett 98208 337-4654 <br />PHONE <br />TENANT <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />Owner <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />HARSTCI144DJ <br />LICENSE♦ <br />MECHANICAL CONTRACTOR <br />MAILAODRESS CITY ZIP <br />PHONE <br />LICENSED <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS CITY ZIP <br />PHONE <br />LICENSE. <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION <br />❑ ALTERATION ❑ REPAIR ® DEMOLITION <br />G BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO IF OTHER THAN ABOVE <br />CONTRACT PRICE OF WORK: $ <br />DESCRIBE WORK, AND SOUARE FOOTAGE <br />INVOLVED <br />Demolish House <br />PROPOSED USE OF BUILDING <br />SFR <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />6 10 <br />LOT _- BLOCK _ OF <br />Beverly Hills Div #2 <br />JOB ADDRESS <br />6531 Olympic Dr. <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EOUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C - AMNDLG UNITS - H.P. <br />BATHTUB <br />FORCED AIR SYSTEMS - B.T.U. M EA <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK & DISP. <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />' <br />LAUNDRYTRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE A CHIM Y ' <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT NM5` <br />FLOOR DRAIN <br />HEAT PUMP 9EWER.` <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS - RAINLEADERS <br />EXHAUSTFAN WATER. <br />SINK (SERVICE - BAR, ETC) <br />SUBTOTAL <br />f <br />SUB <br />f <br />PERMIT <br />S1 <br />--Slv <br />TOTALFEE <br />f <br />TOT <br />f <br />TJ <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />R SRCH 4..50 <br />F sgr <br />EIPT NO <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />41 I IG CODE <br />FEE <br />PVPE OF CONSTRUCTION ALLOWABLE <br />TYPE OF CONSTRUCTION ACTUAL <br />�q 'p` <br />NO OF DWELLING UNItS <br />BUILDING <br />A <br />yHCLK $199 <br />.00 <br />PLUMBING <br />SIZE OF BLDG <br />NO OF STORIES <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />OCCUPANCYLOAD FIRE SPRINKLERS RED <br />p YES ❑ NO <br />REASON FOR SPRINKLERS <br />HEIGHT LIMITATION <br />OTHER <br />STATE BUILDING SURCHARGE <br />3 <br />50 <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />M.M. <br />PLANS APPROVED BY <br />J.W. <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS <br />slns...,. <br />PUBLIC WORKS <br />TOTAL <br />3150 <br />._ _..._. <br />.... _ ..._ <br />PERMITS EXPIRE IF WORK IS NOT COMMENTED WITHIN ADDRESS FILE 22168 <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />