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• Ilt\\O ti \-c.KS:rce--'"----( <br /> .4ia4 PERMIT APPLICATION <br /> BUILDING I MECHANICAL / PLUMBING I SIGN / SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES X- <br /> STREET,EVERE I I,WA 98201 . <br /> ' <br /> 3200 CEDAR OLA,(.1\SL <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwagov 1 www.everettwa.gov/permits P..u.nts.O A-- <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> V..-•- v N <br /> PROJECT SITE ADDRESS:2110 Rockefeller Ave. Everett,WA 98201 PROPERTY TAX#:00437043602802 <br /> LEGAL fur new construction', Short Pit:It/subdivision tot No ?oiloc-i copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Taylor Fjeran&Michael List TENANT BUSINESS NAME(Commercial); <br /> , <br /> OWNER MAILING ADDRESS: siREET 21 10 Rockefeller Ave. <br /> Everet1 rtATE WA z,p 98201 <br /> t <br /> OWNER PHONE: (425)359-4751 &(425) 446-9506 OWNER EMAIL:taylor.fjeran@ gmailcorn <br /> CONTRACTOR NAME:SELF <br /> CONTRACTOR ADDRESS: STREET <br /> CiTY S <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE C/REQUIRED): <br /> . .._ <br /> PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:(425)359-4751 &(425)446-9506 <br /> Taylor Fjeran & Michael List CONTACT EMAIL:taylorMeran@ grnail.corn <br /> BUILDING INFORMATION <br /> Existing Use of Building:Detached garage Contract Price of Work:kg_ <br /> Proposed Use of Building:Demolition Of detached garage Heat Source: OGas DElectric 00ther N",!,,, <br /> BUILDING USE; OSFR EITownhouse CDuplex JADU 0Multi-Family7#Units: EJCominercial Accessory Structure <br /> Type of Project: New DAddition DRemodel L2Repair LT.I, 0Sign Sprinkler ZIDemotition 0Change of Use <br /> DESCRIPTION OF WORK: <br /> We intend to ciernoiiSh the existing detached garage, <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLOMBING PERMIT APPLICATION <br /> • ... ... <br /> fixtere Fixture Fixture Fixture <br /> Count List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Count Count Count <br /> AIC-Air Handling Units Gas Piping Backflow Priuventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer 5:Mt-Commercial(3-comp,prep,ficor) <br /> . <br /> Clothes Dryer Heat Purnp&Ductless -Dishwasher Sink-Resioential fkitchen.bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry.mop <br /> - <br /> Exhaust Fans(Residential) Commercial Ventilator Floor Drain Toilet <br /> Exnaust Hood/Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease WasteAqater Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace I s,en Log ' Roof Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> V'e a[er Suppressiori SysTem ..No:of Heads ' <br /> - <br /> Unernical Suppressioq System No.of Heads <br /> -- ..- ,... . <br /> ACK NOWLEDGEMENT 1 have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to Via:permit must comply with <br /> criri,nr Wenn 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 <br /> Go limp OfficiaI before being authorized under any circumstance.I am the owner,or/am authorized by the owner of this property to perform the work for winch application is made, <br /> arid I comply with the State Contractors Law 18,27 RCW and 2P6,200A WAC. <br /> PERMIT <br /> City of Everett Official Use Only <br /> '2'''.? •''''''.1:i / •• .. .e- <br /> i2...ac; ...... <br /> '' ) if '1''''' <br /> 7 ' // P tlf) (‘ <br /> , .. <br /> , • <br /> Owner/Authorized Agent Signature Date (Revised 10/1 2018) <br />