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� �a � <br />A�lx <br />>H[~i� <br />C <br />H � <br />1Q (� <br />H �1 <br />� H � <br />V1 H <br />C110� <br />H t7 <br />H�8 <br />(�]Y �] <br />t�y� <br />HH <br />g�' <br />H <br />c� G y <br />��� <br />z�3cn <br />HOp� <br />""�`�'�`'���`�'�" (' 7NSTRUCTION <br />CiTY OF -7 <br />�verett PERMI�" PERMIT NO. �`�� I� <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />�11'fYER 1.1M1/�UOIIESS CIIV ZI�' PIIORE <br />Everett School DIst. 2302 Bverett Ave. Everett 9�201 339-4350 _ <br />iU�ANi RI�IlAO0qE55 CITY ?IP PMONE <br />411fNRELTOPDE5IGNE❑ MALLP��PCSti CILY ZiP FMONE <br />GENEIIALCONTPACTOII ��AILAO��E55 CITV ZII' �MON[ LICkN^Le <br />rnaner <br />h�CQUNICALCONTRFCTOR MAilAO0f1E55 CITY ZIP PMON[ LIC[NSL. <br />PLI�MpiNGCONiRI.ClOf1 ��NtADORE55 CITY ZIP PMONE LICENtiC+ <br />cuss or wonK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ HEPAIR ❑ OEMOLITION ❑ BUILDING PELOCATION <br />CONTRACT PRICE OF WORK'. S <br />OESCRipE WOPMANOSOUAREfOOfAGEINVOLVED <br />Portable classroom <br />veoaoseo use or om�owc <br />Classroom <br />IEGAL OESCNIPiION Of PROPERTV ISNO W �ELOIY OR ATinCN iOUR COPIE51 <br />wr -- o�ocK — o� <br />�oo nooness <br />1110 Poplar <br />PLUMBING <br />NO. TYPE OF FI%TURE OI <br />WATER CLOSET (TOILET) <br />BATHTU� <br />LAVATORVIWAShIBASIN) <br />SHOWER <br />KITCHLN SINK 8 DISP. <br />DiSHWASMER <br />IAUNORVTRAY <br />CLOTNES\YASHER <br />URINAL <br />DRINKING FOLINTAIN <br />FLOOR DflAIN <br />BACKFLOW PREVENTERS <br />ROOP DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR. ETC.) <br />US[ ZONE <br />SPU <br />h!L Oi CONSiPUCIION Al lON <br />RiI� <br />size or o�oc <br />stair only <br />occurn�+c� �nno <br />N/A <br />nc.+sorv ron saim�K�er <br />ACC L]Y <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />pEnA sEtn�r.K <br />IOiPPEA <br />n rc or cmis�wcnvi nciwa <br />V—N <br />NO OF STORiCS <br />1 <br />FlRE SPRINNLERS �EOD <br />❑ VES Q NO <br />S.19. <br />coHTnCt �[nsarv srvc rrvw� n� �..� �„�.. �,,..,...�..... <br />, stairs <br />�S <br />sioE sErnacK <br />VPCANTSrtE <br />❑ YES ❑ NO <br />MECHANICAL <br />��p, TYPE OF EOUIPMENT <br />A/C — AMNDLG UNITS — H P. <br />FORCED AIP SYSTEMS — B TL M EA. <br />UNITHEATERS—B.T.0 M <br />CLOTMESDRYERS <br />VENTILATION FAN <br />RANGEMOOD <br />\vATER IIEAiER <br />WOOOSTOVE <br />METAL FIFEPLACE 8 CHI/dNEY <br />FIREPLACEINSEFT <br />HEAT PUMP <br />G�S PIPING <br />EXHAUSTFAN <br />CHECN NUAI�ER <br />SI1B TOTAL <br />PERMIT <br />TOTALFEE <br />arp �,r.. No ci oa�«u�runn5 BUIL�ING O/ lai �� <br />� PLUMBING NOOOO?• <br />o�see�er�ry ELEC <br />❑ YES C] NO MECHANICAL <br />MEIGNI LIS�IiATION L� <br />OTHER eLp <br />STATE DUIl01NG SURCHARGE F �CN <br />STATEEN[RGVSURCHARG[ � <br />CITY OF EVERETT pUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS TOTAL <br />3105 yyHEN PRO!'ERLY VALIDATE <br />PERMITS EXPIRE IF WORK IS NOT COMMENCED WITHIN �pDR[SS FlLE <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />��� <br />f <br />S � ' <br />PECEIPT NO ', <br />�E FEE <br />a:o n 000aao4�go y.:�:c ' <br />.00 , <br />.0� <br />'.5D 4 50 <br />34 50 <br />IS YOUR PERMIT <br />_ <br />