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� <br /> ,"eE''CTVOF CONSTRUCTION � <br /> everett PERMIT pERMIT NO. 1O105 <br /> CITY HALL 259�8745 <br /> EVERET7.WA 98201 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> OWNER MFILADDBE55 CITY 21P PNONE <br /> GERALD J. RODGERS 1805 HEWITT �VERETT 98201 259-9809 <br /> APCHITECI M UESIGN[R MRIL ADDRESS CITY 21P pHONi <br /> GENERAL CONTFFCiOR MAq ADDRE55 CITY ZiP PMONE I�CENSE 1 <br /> MECHANICAL CONTqA(;tOP MAII ApDAE55 CITY 21P PHONE UCENS[1 <br /> Jorgenson Sheet Metal <br /> PWA161NGCONiRACTOR MAILADDRESS (;ItY 21P PNONE �ICENS[1 � <br /> LLA55 O(N'OfiK <br /> 1�NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑OEMOLITION ❑FENCL ❑SIGN ❑GARAGE <br /> VALUATION OF WOPK <br /> , 950.00 <br /> D[SCRI�E IVORK <br /> Frame shaft and install duct <br /> PROPOSED W[OI BWLDING <br /> REStdllrdrit I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> LEGRL DiSGRIPT10N OF PqO�EPLV�SNOW BELOW OP ATTACN FOIIF CAPI[5� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior e�oc�_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPEGFIeD <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT OOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> JOUP�DR[55 <br /> SiGNAiUAE OF CONiRnCtOfl OR AUINORIZEO AGENT DAiL <br /> 1805 Hewitt Ave X .,� 12/21/81 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM fEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOS[T�TOILEi) AIR COND.UNITS—H.P.EA. <br /> BATHTU[3 fiEFRIGERAiION UNITS—HP.EA <br /> LAVATORY�WASH�ASIN) BOILERS—HP.EA. <br /> SHOW[q GAS FIRED A C UNITS—TONNAGE[A. <br /> KITqiLN SINK E UISP. FORCED AIR SYSTEMS—8 T.LL M EA. <br /> DISHWASN[F \NALLHEATERS—BT.U. M <br /> LAUN�RY TRA1' UNIT HElQERS—�T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLEPS <br /> WATEF HEATER CLOT4ES DRVEHS <br /> URINAL VENTILATION f-AN 0 <br /> DRINKING FOUNTAIN ], RANGE NOOG <br /> FLOOR�PAIN AIR HAN�I.ING UNIT— C.F.M. <br /> VACUUM�REAKERS STOVE <br /> ROOF DRAINS—RAWLEA�ERS METAL FlREVLACE&CHIMNEY <br /> SINK�S`_RVICE—�AR.ETC.1 <br /> SU9 TOTAL SUBTOTAL f <br /> PERMI7 S PENMI7 3 3 OO <br /> 70TAL FEE S TOTAL FEE S lO <br /> SIDE YARU SET�ACK STRE[T SETBACK REAR VARD SET�ACK FLAN f.H[CH NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> l]YES I:NO FEES VALUATION FEE <br /> TYPE OF WNST. OCCUPANCV GROUP NO.OF DWELLMG UNITS <br /> BUILDMG S <br /> SIZE OF �LDG. NO.OF STORIES MA% OCC.LO�D <br /> PLUAI�ING <br /> FlRE ZONE BASEMENT FIRG SPRINKIERS — <br /> REOUIRED MECHANiCAL <br /> I.1VES [;NO _ <br /> APPPOVALS BY DA7E OTHER -- <br /> - 1. ENVIRONM6NTAL CHECK UST pENALTY U.B.C. <br /> 2, dUILDING PIANS SEC.303(e) <br /> 3. RFC HVDRANi TOTAL <br /> a. FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PROPERLY VAUDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GHADING <br /> ; �. ' -- � � <br /> 6. DRAINAGE � � <br /> � <br /> 7. ENVIRONMENTALIMPACTSiATEMENT � <br /> 8. HEALTH DISTRICT . � <br /> APPLICATION ACC.BY PLANS CHECKED�V APPR.FOR ISSUANCE BY ' ' ' � <br /> i <br /> ADDRESSFILE i ,,...; � ; <br /> '1 <br />