6103 ROCKEFELLER AVE 2021-02-24 - Laserfiche WebLink

mom PERMIT APPLICATIO'' lizi BUILDINOMECHANICAL I PLUMBING / SIG PRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: w I©- 121 ere II Qi gLie, PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: D e c't i-, /t✓'rt9'\ TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 2--3/©T�^\ �/ ' Le, A)� �C- /- L ' / Q CITY kC, e l 1 STATE L e Ill- ZIP / O a OWNER PHONE: 2_CC - /c.:SC /63C- OWNER EMAIL: C4C Uio)T-e (31zJ/S f IL (n''lle`5 i1e7i- CONTRACTOR NAME: a C-c)n-P r Co CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: f'OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Z QG, — ? .26,` 5--- "Peg.y1 P.e )-er>0 f`"1 CONTACT EMAIL: ic.,�e.20jhe/r)Pf-4t) 91" C 5A , 11 PT BUILDING INFORMATION Existing Use of Building: 1 I'(4.-jNY\cL-) Contract Price of Work:$ Proposed Use of Building: 6Z' I C't r C� Heat Source: OGas Electric ❑Other N��I h- /Ak r-nf BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: _ ❑Commercial ❑Accessory Structure Type of Project: ONew ❑Addition El Remodel El Repair ❑T.I. ❑Sign El Sprinkler ODemolition ❑Change of Use DESCRIPTION OF WORK: E ,.,I©i'- ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures 0 NC—Air Handling Units ( Gas Piping Backflow Preventer(Inside Bldg) Z Shower,Tub,or Combo Boiler Gas Range ! Clothes Washer Sink-Commercial(3-comp,prep,floor) I Clothes Dryer I Heat Pump&Ductless t Dishwasher 3 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop 4,.3 Exhaust Fans(Residential) Commercial Ventilation Floor Drain 2- Toilet Exhaust Hood(Type I) (Not Heat/AC system) 3 Hose Bibb Urinal Exhaust Hood(Type II) I Water Heater Interceptor-Grease Waste/Water Piping Repair I Exhaust Hood(Residential) t , Wood Stove Interceptor-Sand/Oil Water Service(behind meter) I Forced Air Systems Other: Medical Gas Water V Ives or Fixtures e, Gas Fireplace/Insert/Log G Roof Drains .11(l Hea SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads. ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained 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 wit - -tate Co tractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT0 I q O S'Oo Owner/Authorized Agent Signature Date (Revised 4/15/2019) a_ :