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NINII PERMIT APPLICATION <br /> BUILDING�MECHANICAL / PLUMBING / SIGN / RINKLER / 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:3308 Rockefeller Ave, Everett WA 98201 PROPERTY TAX#:00436979202900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 3308 Rockefeller Ave, LLC TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET P.O.Box 1094 <br /> or( Woodinville STATE WA ZIP 98072 <br /> OWNER PHONE: 425.244.0007 OWNER EMAIL:ismail.seattle@gmail.com <br /> CONTRACTOR NAME:Owner/TBD <br /> CONTRACTOR ADDRESS: STREET P.O.Box 1094 <br /> ciry Woodinville STATE WA ZIP 98072 <br /> CONTRACTOR PHONE:425.244.0007 CONTRACTOR EMAIL:ismail.seattle@gmail.com <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: CI OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425.244.0007 <br /> Ismail Mohammad CONTACT EMAIL:ismail.seattle@gmail.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:SFR Contract Price of Work: $ 15,000 <br /> Proposed Use of Building:Conversion of Basement to living space Heat Source: OGas DElectric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units:3 ❑Commercial EAccessory Structure <br /> Type of Project: ❑New ❑Addition ✓❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Conversion of existing basement into living space <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> F re Fixture 'Fixt Fixture <br /> Co. List of Fixtures count List of Cou List of Fixtures Count List o <br /> • C-Air Handling Units G.- . g , Preventer(Inside Bldg) 2 Shower ombo <br /> a• 2 - Range 2 Clothe , • •er ercial(3-comp,prep,floor) <br /> 2 Clothe . - Heat Pump&Ductless 2 Dishwasher fnk-Residential(kitchen,bath,bar) <br /> Duct System -•de Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> 4 Exhaust Fans('- . •• Commercial Ventilatior 1 Floor Drain 2 Toilet <br /> Exhaust • pe I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exha •od(Type II) _ Water Heater Interceptor-• e te/Water Piping Repair <br /> •st Hood(Residential) -•d Stove Interc- 'and/Oil Wa- : e(behind meter) <br /> ced Air Systems Oth- Me• : Gas Water Valv- ures <br /> es Fireplace/Insert/Log Roo Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No of Heads <br /> Chemical Suppression System INo.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 being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors e.27 W and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 114C -'>ii\i <br /> PER <br /> 1 May 18th,2020 D�c <br /> Owner/Aut_ nt Signature Date (Revised 10/10/2018) <br />