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

• PERMIT APPLICATION • 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:3102 Rockfeller Ave PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Canfield Madow Law Group TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 3 7 3 L P/z ' CITY // �i I/$ f/� l�Q STATE t,i/ ZIP SZ,rO OWNER PHONE: / OWNER EMAIL: CONTRACTOR NAME:Right Way Plumbing Heating A/C Inc CONTRACTOR ADDRESS: STREET 647-A Sunset Park Dr CIT. Sedro-Woolley STATE Wa zip 98284 CONTRACTOR PHONE:360-855-2665 CONTRACTOR EMAIL:ed@rightwayplumb-heat.com CONTRACTOR LICENSE#(REQUIRED):rightwpo77ns CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 30 3 /q ? PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ID OTHER(Please Specify) Plumbing Contractor CONTACT NAME: CONTACT PHONE:1-360-661-6501 Ed Clark CONTACT EMAIL:ed@rightwayplumb-heat.com BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $$17.000 Proposed Use of Building: Heat Source: IGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse EDuplex EADU ❑Multi-Family-#Units: I lCommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑✓Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Re plumb water and sewer ASSOCIATED BUILDING PERMIT#(if applicable): B1909-028 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 fir 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 Heat Pump&Ductless 1 Dishwasher IF 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) 2 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 1 Water Heater SPRINKLER/SUPPRESSION SYSTEM 1 EXG 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 of Everett Official Use Only PERMIT ` �/� 0'r jz--3� / \1 L-- VJ- Owner/Authorized Agent Signature Date (Revised 10/10/2018)