1609 ROCKEFELLER AVE 2021-04-01 - Laserfiche WebLink

4-17. PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING / SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Olin or Black Ink Only Pl•as!) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1609 1/2 ROCKEFELLER AVE PROPERTY TAX#:00438233800500 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: GWEN ANDERSON TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1609 1/2 ROCKEFELLER AVE ciT- EVERETT STATE WA ZIP 98204 OWNER PHONE: 425-367-4714 OWNER EMAIL:NA CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY ciTv EVERETT STATE WA zip 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098 PRIMARY CONTACT: ❑OWNER D CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$4600.00 Proposed Use of Building: Heat Source: DGas DElectric ❑Other BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Sign ❑Sprinkler IlDemolition ❑Change of Use DESCRIPTION OF WORK: LIKE IN KIND FURNACE CHANGE OUT �(J k3L— 46 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 A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler _Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) _Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) r Forced Air Systems _Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads j 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 with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# /�C9ci,Z-(11/94 21/0424 12/20/18 ga . 0q(4 Owner/Authorized Agent Signature Date (Revised 10/10/2018)