3102 ROCKEFELLER AVE CANFIELD MADOW LAW GROUP 2022-11-28

PERMIT APPLICATION BUILDING�ECHANICAL I PLUMBING/SIGN •RINKLER/DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa_gov I wuwu.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:3102 Rockefeller Avenue PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Rockefeller Building LLC TENANT BUSINESS NAME(Commercial): Canfield Madow Law Group OWNER MAILING ADDRESS: STREET3732 94th PL NE crry Marysville STATE WA zip 98270-9111 OWNER PHONE: 425.212.1+8 OWNER EMAIL: CONTRACTOR NAME:Righ4ay Plumbing,Heating,Air Conditioning Inc. CONTRACTOR ADDRESS: sTREET 647 STE A Sunset Park Dr. CITYSedro Woolley STATE WA ZIP98284 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):CC RIGHTWP077NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 30399 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR El OTHER(Please Specify) General Contractor CONTACT NAME: CONTACT PHONE:206.372.6933 Chris Simmons CONTACT EMAIL:Chriss@joesimmons.com BUILDING INFORMATION Existing Use of Building:Office Contract Price of Work:$25,000.00 Proposed Use of Building:Office Heat Source: OGas DElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ✓❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Installation of new split-system/ductless heat pump as part of larger project under separate permit ASSOCIATED BUILDING PERMIT#(if applicable): B-1909-028 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 11 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation 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 I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 ty of[Everett Official Use Only it l P IT 1 I 17-/2o7-o Owner/Authorized Agent Signature Da (Revise 10/10/2018) 61