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theEc���„ � .-�ONSTRUCTIOM-°�. � <br />eV('.Y'@tt PERMIT PeRnniT No. _�� o�l �, <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br />O\YN[R MAIL A�DRESS CITY ZIP PMONE <br />Everett Housing Authority 1401 Poplar Everett 98201 258-9222 <br />TENANT M�ILADDRESS LITY ZIP VMONE <br />RNCHRECT OR DESIGNER AIAIL A�UFE55 CITY 21P PNONE <br />GENENAL CONTRACTOR AIM� ApDRE55 CITY ZIP PHONE UCENSE • <br />MECHANICALCONTRACTOR MMLADDRE55 CITV ZIP PMONE LICENSE• <br />.Toe's Plumbing PO Bx 1137 Lk Stevens 98258 334-1309 .TOGS**235C2 <br />PLUM9INGCONTNACTOR MFILAOORESS CITV ZIP PHONE LICENSE� <br />CLFSSOFWCRN - <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ HEPAIR ❑ DEMOLITtON ❑ BUILDING RELOCATION <br />CONIACT FERSON AND PHONE NO. IF OTMER THAN ABOVE <br />CONTRACT PRICE OF WORK: S 1328. S6 <br />uca�n�oc wvnn nnu owNno r�u�nuo �rvvv�vc� <br />Gas Piping 04/25l91 B:24Aii OOOAk6657 lt�k <br />k000^c6869 <br />PnOPO5E0 USL OF BUILDING • <br />4 plex N00026870 <br />OF PflOVEPTV �SHOW BELOW OR ATTACM FOUR WPIES� <br />N�0026871 <br />LOT _ f1LOCN _ OF <br />HOOOi6872 • <br />H000�6873 <br />JOB nDDRE55 • <br />1223 Poplar Street CHECf; $�75.00 <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE ON ITEM FEE NO. TYPE OF E�UIPMENT FEE <br />WATER CLOSET ITOILETI <br />SHOWER <br />KITCHEN SINK 6 DISP. <br />CLOTHES WASHER <br />URINAL <br />OflINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAR. ETC.1 <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />REARSETBACR <br />USEZONE LOTAREA <br />iVf40FCON5IHUCIWNALLON'4BLC lYffOfCOH <br />NO OF STOPIES <br />S <br />S <br />S <br />�RpqCK <br />VACANT $ITE <br />❑ VES ❑ NO <br />ncruai �;,�^,�� xo or oi <br />❑ YES ❑ NO <br />OCCUPANCYLOAD FIRESFNINNIERSRE00 HEIGMTLIlAITATION <br />❑ vES ❑ NO <br />BY CITY OF EVERETT <br />LOCALSALES <br />TAX CODE IS <br />3105 <br />A/C — A/HNDLG UNITS— H.P. <br />FORCED AIR SYSTEAIS — 6 T.U. M EA. <br />UNITHEATERS—B.T.U. M <br />CLOTNESORVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />h1ETAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUA1P <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />CHECKNUMBER FEE <br />FEES e�aoi <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />S <br />�f <br />RECEIPT NO. <br />551 00 <br />55�00 <br />� �: <br />PERMITS EXPIRE IF WORK IS NOT COMMENCEO WITHIN 'l (; S''7 � <br />ADD(iESS RLE �� �l , �. <br />180 DAYS OR CEASES FOR MORE THAN 180 DAYS. <br />