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PERMIT APPLICATION <br /> BUILDING / HANICAL/PLUMBING/SIGN /SPR ER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3102 Rockefeller Ave. PROPERTY TAX#:00439173802800 <br /> LEGAL for new construction: Short Plat/subdivision EVERETT PLAT OF BLK 738 0-00-LOTS 28 8 29 Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Rockefeller Building LLC TENANT BUSINESS NAME(Commercial): Canfield Madow Law Group <br /> OWNER MAILING ADDRESS: sTREET3732 94th PI NE <br /> c,Ty Marysville • STATE WA. ZIP 98270 <br /> OWNER PHONE:425.212.1825 OWNER EMAIL:rmadoW canfleldmadoW.cOm <br /> CONTRACTOR NAME:Joseph S. Simmons Construction <br /> CONTRACTOR ADDRESS: STREET3223 NE 125th St. <br /> c„., Seattle STATE WA ZIP 98125 <br /> CONTRACTOR PHONE:206.372.6933 CONTRACTOR EMAIL:chrlss Q@joesi mons.com <br /> CONTRACTOR LICENSE#(REQUIRED):W do6EpSS ICJ3J b CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <�L <br /> C) <br /> PRIMARY CONTACT: El OWNER 0 CONTRACTOR El OTHERrn OTHER(Please Specify) Architect (MO 61 ' 17) <br /> CONTACT NAME: CONTACT PHONE:425.317.8017 <br /> Sandra Higgins CONTACT EMAIL:sandra@caparchgroup.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Law offices Contract Price of Work:$ ��,DOC) <br /> Proposed Use of Building:Law offices Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ElDuplex DADU ❑Multi-Family-#Units: ZCommercial ❑Accessory Structure <br /> Type of Project: ❑New DAddition ❑✓Remodel ERepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Renovation and remodel of existing interior finishes, doors, lighting; minor new wall framing and infill. <br /> Upgrade existing elements for accessibility as required. <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) 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 Ventilatior 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/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System 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 /> Buildin cial 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, <br /> an omp ith the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> QCity of Everett Official Use Only <br /> � PERMIT( t 0 ` „ (/ V <br /> Own IA r' e ge ' ature Date (Revised 10/10/2018) <br />