423 ROCKEFELLER AVE 2023-05-31 - Laserfiche WebLink

NIS 0 PERMIT APPLICATIOi O nil BUILDING i MECHANICAL/ PLUMBING /SIGN 1 SPRINKLER/ DEMOLITION E V E R E T T 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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION JJ�� PROJECT SITE ADDRESS: 42.3 Inc\ ke Ile i PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision_ Lot No.I Zit 13(attach copy of long legal description) CONTACT INFORMATION • OWNER NAME: H 1 XC.V 'i3t t'. c5 1k11i1 eS TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET v 2 2 t--1', A' IQ �]Q CITY �I ySk 1 STATE W ZIP Q0 2 6 OWNER PHONE: t-\2S Z QC--2'29 'OWNER EMAIL: ©e\e'haatL4. rc 4 e4-S, (00M CONTRACTOR NAME: 00,64: 13 f o 4�1\e irS -y ee CONTRACTOR ADDRESS: STREET 3 I'4 a c 5'1+Y A,A,-;-,_ N C CITY MCA f y!)0,\\te_ STATE WA, ZIP 2 2-7 0 CONTRACTOR PHONE:tk 2 5 ' 2a 0-2y 2.q CONTRACTOR EMAIL: J be.k \- G C C 6 hro hers, C c' ikil CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O 5 3 9 fd 7 PRIMARY CONTACT: ❑OWNER IPCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: L'Z c 2 q 0-2 2 9 7cDe 1 ‘-kCk(XC-G CONTACT EMAIL: ,e‘ee1010. cL blO#Inevs. (.,o►M BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ Li as- tC Proposed Use of Building: S F g- Heat Source: ®Gas DElectric ❑Other BUILDING USE:IgiSFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Court L.'st of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler I Gas Range ( Clothes Washer Sink-Commercial(3-comp,prep,floor) / Clothes Dryer Heat Pump&Ductless / Dishwasher _ 6 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain _ i Sink-Utility,laundry,mop 9Exhaust Fans(Residential) Commercial Ventilatior Floor Drain 3 Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) l Water Heater Interceptor-Grease Waste/Water Piping Repair / Exhaust Hood(Residential) Wooi Stove Interceptor-Sand/Oil / Water Service(behind meter) / Forced Air Systems Other: Medical Gas Water Valves or Fixtures _ i Gas Fireplace/Insert/Log Roof Drains a H er SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.cif Heads Chemical Suppression System I No.of Heads `ACKNOWLEDGEMENT:I have reviewed this application a.id 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 circums'ance.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 aiId 296.200A WAC. City of Everett Official Use Only PERMIT 7j7J 6us01• OL3 Owne uth rized Agent Sign e Date (Revised 10/10/2018) IiZ