3516 ROCKEFELLER AVE 2024-06-24 - Laserfiche WebLink

BUILDING PERM R APPLICATIO N CITY O FEVERETT PERM rr SERVICES E V E R E T T SUBM ITTAL INSTRUCTIO NS: See applicable subm ttal checklist for subm ttal requirem ants and num ber of copies required for review, WASHINGTON then drop off com pleted application plus all required subm ttal docum eats to 3200 Cedar Street 2nd Floor Intake Drop Box. CO NrACT INFO RVI ATIO N (P)425-257-8810 1 (E)Perm tServices@everettwa.gov I(W)everettwa.gov/perm is (Blue or Black Ink O dy Please) PRO.EC TSITE IN FORM APD N PRO.ECT SITE ADDRESS: STREET 3156 Rockefeller Ave PARCEL#: CITY Everett W STATE A z,P 98201 SUITE/UNIT#: A& B FLO O Int: ADDITIO NAL LO CATIO NINFO RVI ATIO N(if applicable): TENANT/BUSINESS NAME(if non-residential): LEG AL DESCRIPTIO Nfor new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) C 0 N T A MIR F 0 R M ArD N OWNER NAM E3516 Rockefeller Ave LLC OWNER M AILING ADDRESS: STREET P O Box 1094 CITY Woodinville STATE WA ZIP 98072 OWNER PHO NEA25.244.0007 i O WMR EMAIL: smeii.seattle@gmeil.com CO NrRACTO RCO M FANY NAM EOWner/Contractor WA STATE CO NrRACTO RLICENSE#(REQ URED): CITY O FEVERETT BUSINESS LICENSE#(REQ URED): CO NrRACTO RADDRESS: STREET CITY STATE ZIP CO NrRACTO RPHO M: CO NrRACTO REM AIL: PRIMARY CO MACT: DOWNER ❑CO NFRACTO R ❑O 7HER(Please Specify) CO MACT NAM E CO NrACT PHO M:425.244.0007 1 s m a 1 M o h a m m ad COIACTEMAL:iSmail.seattle@gmeil.com BULDNGINF0RMArDN VALUATIO NO FWO R4: $2900.00 ASSO GATED LAND USE PRO.ECT#(if applicable): (Valuation shall include the prevailing fair m arket value of all labor,m aterials,and equipment needed to com bete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Duplex PRO P O ED USE O FBUILDING:DUpleX rem oriel HEAT SO IRCE: ❑G a; ❑✓Electric ❑O her BUILDING TYPE: ❑SFR ❑Townhouse ❑✓Duplex ❑ADU ❑M tlti-Fam iy-#Units: ❑Com m ffcial ❑Accessory Structure TYPE O FPRO.ECT(check all that apply): ❑New Construction ❑Addition ❑✓Rem odel [-]Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration [-]Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub [-]Tank(above ground) ❑O her: DESCRIPTIO NOF wo R<:Interior Sheet Rock Rem wal ACKNO W EDG BW EIVT I have reviewed this application and confirm the inform dion contained herein is true and correct. Work done pursuant to this perm t m tst com#y with current federal,state,and local law. The granting of a perm t only authorizes approved work and no deviations therefrom.Deviations m tst first be authorized in writing from the Building O ficial before being authorized under any circum stance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is m ale, and I com/dy with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett O ficial Use O dy PERM IT# 01/31/2024 0 w sr/Authorized Agent Signature Date (Revised 4/21/2022)