2532 ROCKEFELLER AVE 2024-02-12 - Laserfiche WebLink

• PERMIT APPLICATION• BUILDING / MECHANICAL I 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 Plea) L- PROJECT SITE INFORMATION 2)d PROJECT SITE ADDRESS:, 1 2,(pt1r7� ( / ctj- iLAJ - ! ) PROPERTY TAX#: Do5 62_41542 3 617 b (S LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) I CONTACT INFORMATION 41.OWNER NAME: Ca 1 VGw L„( . ed-n 011,441 TENANT BUSINESS NAME(Commercial): 54rsi` OWNER MAILING ADDRESS: STREET 54,,4E CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: DGi,PPv+ (tn rucht,,, AA CONTRACTOR ADDRESS: STREET 5 J}e8 23 ter•( Ave. L CITY kcr STATE 1.,,1 1 ZIP 7 g CONTRACTOR PHONE: (�3Lo0) 7 tj Y 7/� CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): IV' cp 5 V-1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (Li 2 3) (_ 2(o _ 5 3 53 Nezite P44-1'-i CONTACT EMAIL: NI _ ?ed.is S pro f tt-14$ . tcovi BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ e' rC,"'1) Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTI. ❑Sign LiSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ® aeti ac 1L 41OA ASSOCIATED BUILDING PERMIT#(if applicable): 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 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/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 w. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Offic' I before being a t rized 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, and 1 comp ith the State C tr ctors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only \ 1^ PERM12e) r Df ', Owner/A on A nt S ature I Datt (Revised 10/10/2018) �•`y