3112 ROCKEFELLER AVE 2021-08-27 - Laserfiche WebLink

IMM • PERMIT APPLICATIONS BUILDING MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ 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: 3 a - e Ile,)r A 0(2 PROPERTY TAX#: LEGAL for new construction: Short Platisubdi•"ision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: X'(`k C ka e-i rotx TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CRY F M-et.../ STATE W a ZIP 9 K OWNER PHONE: `.71a26.- -- 3 3 OWNER EMAIL: J b er^r Cr' Q bk'rr'er-la w j t c %-,n CONTRACTOR NAME: leaf c1 -� X ZejrY1!)CI c-Pj'Ot(I CONTRACTOR ADDRESS: sTREEr ) 7CI() 59___CA S cITM S` b' v')rv\ h STATE (,r)A ZIP c-i$ 9,6 CONTRACTOR PHONE: (- 3 .. 9,1rx„ CONTRACTOR EMAIL: CAnyleA.k 6.) 17-OLLcSanCflS1OO( ,c0,1.1 CONTRACTOR LICENSE#(REQUIRED): =tJ�;ZS�S Q j(. 604 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER f CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: LUS I mLC j-lpin;(oc/ n CONTACT EMAIL: CA rvi\P,He_ �C�U1f rwc.CC.1�+ BUILDING INFORMATION Existing Use of Building: (p i f 2. Contract Price of Work:$ 17,to c6S QC Proposed Use of Building: Cj N Heat Source: ['Gas DElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex OADU ❑Multi-Family-#Units: Kbommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel yiRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: p,,,,,,, CI�� Q )1` C CF;1)101) (0(1F) S�U �S (•Ut �t''� • G12�1Z�tl,( S Le t e,1411 IS f DA , CW 12ce ►v% YA.;Vwl. INCr4 t'�:�c r.� 512 ASSOCIATED BUILDING PERMIT#(if a1rplicabie): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixmr: Fixture Fixture Count List of Fixtures cou' List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backfiow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer _ Heat Pump&Duclless 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) 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 1 No.of Heads ACKNOWLEDGEMENT:I have reviewed this app ication 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 ars circumstance.I am the owner.or I am authorized try the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.2;RCW and 296.200A WAC. ---- _ __ City of Everett Official Use Only PERMIT# . /0/2C-/z4_aC '3 Zo t o 013 Owner/Authorized Agent Signature Date (Revised 10/10/2018) t/