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PERMIT APPLICATION <br /> n mil <br /> BUILDING/ MECHANICAL/ PLUMBING/SIGN / <br /> 3200SPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blas or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3506 Rockefeller Ave PROPERTY TAX#:00438185402700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> °. '" CONTACT INFORMATION '• <br /> OWNER NAME: Todd Ade TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 15703 Larch Way <br /> Cm? Lynnwood STATE WA zip 98087 <br /> OWNER PHONE: 425-239-3735 OWNER EMAIL:bobade77@gmail.com <br /> CONTRACTOR NAME:Paradise Construction Inc <br /> CONTRACTOR ADDRESS: STREET 14751 N Kelsey St#331 <br /> CITY Monroe STATE WA zip 98272 44 <br /> CONTRACTOR PHONE:425-422-1999 CONTRACTOR EMAIL:holmquistl0@msn.com <br /> CONTRACTOR LICENSE#(REQUIRED):PARADCI077PN CITY OF EVERETT BUSINESS LICENSE#(REQUIRE : <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-422-1999 <br /> Galen Holmquist CONTACT EMAIL:holmquist10@msn.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:SFR Contract Price of Work:$129,000. <br /> Proposed Use of Building:No change Heat Source: ❑Gas OElectric ❑Other <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition I(Remodel ERepair ❑T.I. ❑S• n ❑Sprinkler ❑Dem Ition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING'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 /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) 2 Shower,Tub,or Combo <br /> Boiler Gas Range 2 Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> 2 Clothes Dryer Heat Pump&Ductless 1 Dishwasher p it pf eK ...fr." Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountair)p40 N (iv ..A -- Sink-Utility,laundry,mop <br /> 4 Exhaust Fans(Residential) Commercial Ventilatior Floor Drain 2 Toilet <br /> Exhaust Hood(Type I) _ (Not Heat/AC system) Hose Bibb Urinal <br /> �(C4 Exhaust Hood(Type II) Water Heater Interceptor-Grease 2 Waste/Water Piping Repair <br /> ,"� _Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas - �Nater Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains 2 Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System I No.of Heads <br /> Chemical Suppression System No.of Heads <br /> 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 <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 beirr••• - orized 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, <br /> and I comply with the S;j- . tractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> vr _. 5',aa Pzcso% W2, <br /> Own 'thorizer- gent Sig <br /> g 7nj Date (Revised 10/10/2018) <br /> it <br />