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• • <br /> OLT PERMIT APPLICATION <br /> BUILDING I MECHANICAL 1 PLUMBING 1 SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or;BlacklnleOnty;Please) :;:::.:,;:; ::;:PROJECT:SIITE INFORMATION .:.... ...:::..,:., <br /> PROJECT SITE ADDRESS:402 ROCKEFELLER AVE PROPERTY TAX#: 00438610503300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) <br /> CONTACTINFORMAT N'; ::: .:. ::::::.:: ..... <br /> OWNER NAME: ANN SPRIZZI TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREET402 ROCKEFELLER AVE <br /> cm, EVERETT STATE WA ZIP 98201 <br /> OWNER PHONE: 425-220-2080 OWNER EMAIL:annsbrizzi@live.com <br /> CONTRACTOR NAME:GS HEATING <br /> CONTRACTOR ADDRESS: sTeser 3409 EVERETT AVE <br /> crry EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL:MELANIE@GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):GSHEAHC$21 OR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 <br /> PRIMARY CONTACT: ❑OWNER I]CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-610-4257 <br /> MELANIE MENDENHALL CONTACT EMAIL:MELANIE@GSHEATING.COM <br /> Existing Use of Building:RESIDENTAIL Contract Price of Work:$28e9.42 <br /> Proposed Use of Building:RESIDENTAIL Heat Source: ❑Gas (]Electric ❑Other <br /> BUILDING USE I]SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ECommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition CZJRemodel ❑Repair ❑T.I. ESign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> AIR HANDLER INSTALL <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> :: ..;MECHANICAL;PERMIT:APPLICATION;:;,:::;::::; ::::::.:::::::: :- ':;;;::: ..:PL:UMBING•PERMIT;APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC-Air Handling Units Gas Piping . Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water 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/Insert/Log Roof Drains Water Heater <br /> ;;SPRINKLER':1SUPPRESSION;SYSTEM::::::::::::::::. Sewage Ejector or Sump Pump Other. <br /> Water Suppression System No,of Heads <br /> Chemical Suppression System No.of Heads • <br /> ACKNOWLEDGEMENT:l have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance.lam the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and l comply with the State Contractors Law 18.27 ROW and 296,200A WAC. <br /> • City of Everett Official Use Only <br /> - /VL.t aitA;t t, 11.2--P -�o�a-U PE= , CID CO U <br /> Owner/A.utfioiizetl)Agent Signature Date (Revised 10/10/2018) <br />