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the Ev rRnrn <br />CITY Of <br />everett <br />259-8810 <br />C"INSTRUCTION <br />PERMIT <br />I I. <br />PERMIT K,- 21869 <br />Q DEMOLITION D COMBINATION O BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Randy Investment P.O. Box 7575 Everett 98201 252-3409 <br />TENANT MAIL ADDRESS CITY IiP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAR ADDRESS CRY PP PHONE LICENSE A <br />C. Martin Trucking P.O. Box 2716 Lynnwood 98306 778-3106 CMARTT376NO <br />MECHANICAL CONTRACTOR MAIL ADDRESS CRY 71P PHONE LICENSE A <br />MAIL ADDRESS CITY ZIP PHONE LICENSE IF <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION C) ALTERATION ❑ REPAIR XW DEMOLITION O BUILDING RELOCATION <br />GONI ACT PERSON AND ('HONE NO IF OTHER THAN ABOVE <br />CONTRACT PRICE OF WORK: S <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />Demolish Duplex <br />MOMSED USE OF BUILDING <br />Duplex <br />LEGAL DESCRIPTION OF MOPERTY ISHOW BELOW OR ATTACH FOUR COPIES) <br />LOT _ BLOCK 769 OF Plat of Everett- South 5' of lot 3 and all of 4 <br />JOB ADO CSl <br />1!)C 7 nH..4nr <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A -- AL HNDLG 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 />_ <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRYTRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKF'_OW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS - RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE - BAR. ETC) <br />I <br />SUBTOTAL <br />f <br />SUB 'Uf <br />PERMIT <br />f <br />PEf <br />TOTALFEE <br />f <br />TOTA FWLH f <br />FRONTSETBACK <br />REAR FETRACK <br />SIDE'ETBACK <br />PLAN CHECK NUMBER <br />- <br />EIPT NO <br />UCE ZONE <br />LOT AREA <br />VACANT SITE <br />❑ YES ❑ NO <br />FEES <br />BUILDING COEE <br />FEE <br />BUILDING <br />— <br />REOFCONSTRUCTgNALIMABLE <br />TYPE OF CONSTRUCTION ACTUAL <br />o 'K' <br />NO DF DNiLUNG LINItS <br />PLUMBING <br />SIZE OF BLDG <br />NO O' STORIES <br />BASEMENT <br />❑ YES ❑ NO <br />MECHANICAL <br />-- <br />OCCUPANCYLOAD FIRE SPRINKLERS BEG <br />❑ YES C) NO <br />REASONFORSMINKLERS <br />HEIGHT LIMITATION <br />OTHER <br />- <br />STATE BUILDING SURCHARGE <br />-- <br />3 <br />50 <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC. BY <br />S.R. <br />PLANS APPROVED BY <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS <br />3105 <br />PUBLIC WORKS <br />TOTAL <br />WWPM DRlYPFDI V VAI <br />IIIATPn THIS IS <br />VnIIR PFRNIIT <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN ADDRESS FRE 21859 <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />