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® PERMIT APPLICATION <br /> rim <br /> BUILDING / MEC _ANICAL / PLUMBING / SIGN / SPR► _LER / 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 Elack Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3314 Rockefeller Ave, Everett WA 98201 PROPERTY TAX#:00436979202500 <br /> LEGAL for new construction: Short Plat/subdivision__ Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 3314 Rockefeller Ave, LLC TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREETP.O.BOX 1094 <br /> cnv Woodinville STATE WA Lip 98201 <br /> OWNER PHONE: 425.244.0007 OWNER EMAIL:ISmall.Seattle©gmail.COm <br /> CONTRACTOR NAME: OWller <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE LI p <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: El OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:4.25.244•0007 <br /> Ismail Mohammad CONTACT EMAIL:ismail.seattle@gmail.com <br /> BUILDING INFORMATION —' <br /> Existing Use of Building:-&FR' 64Z4GE Contract Price of Work: $2 0 <br /> Proposed Use of Building''ReSldefittat" Heat Source: ❑Gas (]Electric ❑Other _ <br /> BUILDING USE: EISFR ❑Townhouse LiDuplex ❑ADU —4Pk3nits _ ❑Commercial ❑Accessary Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Convert Existing Garage into dwelling !!! <br /> ASSOCIATED BUILDING PERMIT#(if applicable): J <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLI <br /> Fixtu . Fixture Fi Fixture <br /> Count List of Fixtures Count Li ures Coun List of Fixtures Cou List of Fixtures <br /> A ir Handling Units , ping Bac• •• enter(Inside Bldg) �Shower,Tub,or Combo <br /> Boiler ..as Range 1 Clothes Was - Sink-Commercial(3-comp,prep,floor) <br /> 1 Clothes Diy Heat Pump&Ductless 1 Dishwasher 2 Sink-Residential(kitchon,bath,bar) <br /> Duct System(Re el 71 Refrigeration Drinking Fountain Sink-Utility,laundry, mop <br /> 1 Exhaust Fans(Res:• i Commercial Ventilatior` Floor Drain Toilet <br /> Exhaust Hood _ (Not Heat/AC system) Hose Bibb al <br /> Exhaust Ho• ype II) Water Heater Intercepto se Was Piping Repair <br /> 1 Exhaus •d(Residential) •od Stove Interco �• and/Oil Water Servic ehind meter) <br /> Fore ir Systems O th M• as Water Valves or Fixtures <br /> - Fireplace/Insert/Log rains 1 Water Heater <br /> S•RINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.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(horn the <br /> Building Official before being authorized under any ci umstanc .I am the owner,or I am authorized by the owner of this property to perform the work for which application is made. <br /> and I comply with the Sta Contractors Law 18.27 RC nd 2 6.200A WAC.� <br /> City of Everett Official Use Only <br /> 4- / PERNIT3s� �) - ✓��j (�, <br /> 4.- May 7th,2020 /�/` U✓ `� <br /> Owner/Auth ..'�. 'ignature Date (Revised 10/10/2018) <br />