3716 ROCKEFELLER AVE 2019-11-07 - Laserfiche WebLink

PERMIT APPLICATJJ /IPP#101 .".A.— BUILDING/ MECHANICAL/ PLUMBING /SIGN/SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES v ' 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION, PROJECT SITE ADDRESS: -I 12 r✓ . =L4_- PROPERTY TAX#:t96)' ‘' e)1g2`Zol& o 0 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:--10Mbj W( LK\kJ ii TENANT NAME(If Commercial): 3 OWNER MAILING ADDRESS: STREET CITY STATE ZIP --)s, OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY � / STATE ZIP CONTRACTOR PHONE: OLU NI/4y 11Qe CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):/ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT N ! ? l CONTACT PHONE: (Z--- -2,--t—) ' -0 — c �. V CONTACT EMAIL:i'(,m.1SC•Qlkm 'IZI 00ax'1 'L 0- �. coi✓L BUILDING PERMIT APPLICATION _ Existing Use of Building: C � ( 9 ' I-t' - Lc(I '7:;/;-#2-1)));;1 � '—►Contract Price of Work:$ , '► aC iC) Proposed Use of Building: 1.Q tib'(Ai__ SIG Heat Source: ❑Gas ❑Electric 0 uther Building Type: ISR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family#of Units: ❑Commercial 0 Industrial Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1Y11-6t4 ei" rtryto teA +0 -2 ee, Cpl etna) l� iIoVt _lrie• • ASSOCIATED BUILDING PERMIT#(if applicable): I MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION. Type of P .'ect: New_ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration Repair #ofList of Fixtures #of fist of Fixture- #of List of Fi. res #of List of'fixtures Fixtures Fixtures Fixtures Fixtures NC— Handling Units Heat Pump '00 Toilet Backflow P -venter(Inside Bldg) Forced Ai ystems Unit Heater Batht • Urinal Gas Piping Boiler Qu, L-'atory(Wash Basin) grin ' g Fountain Water Heater Refrigeration II Shower F Drain /`y Gas Fireplac- Wood Stove 'chen Sink&Disposal yeas=Trap / Gas Ran.- Ducting 11 Dis asher Roof Dra is Cloth-; Dryer Hookups Other: I Clothe Washer 'edical,Ga- j R. ge Hoodp L tarHter .they: xhaust Fan 1 1 4 , t eyi -/W/ o e ce ^ ,-r SPRINKLER'/`SUPPRESSION SYSTEM i-........ Number of Heads -------` ACKNO 6R MEN. wed this ap 'satbr_Anda rrm thein r cefitallfed herein is true and correct.Work done pursuant to this permit must comply with current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT A A Owner/Aut ,,ri.•: •g,„f t+i.•Aire Date (Revised 5/20/2016)