3529 ROCKEFELLER AVE 2017-01-13 - Laserfiche WebLink

SITE AD PERMIT APPLICATION� BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PEFiMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION �LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) � BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ Proposed Use of Building: Heat Source: Gas ❑Electric ❑Other Building Type: ❑SFR-Detached SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial Type of Pro'ect: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Si n ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: �f �-e t � �i� ►� c� � r/� c� c.� o �, -f --- ASSOCIATED BUILDING PERMIT # (if applicable): PLUMBING PERMIT APPLICATION Type of Project: New Addn _Alteration Repair Fixtures List of Fixiures Fixtures List of Fixtures Toilet Backflow Preventer (Inside Bldg) Bathtub Urinal Lavatory (Wash Basin) Drinking Fountain Shower Floor Drain Kitchen Sink & Disposal Grease Trap Dishwasher Roof Drains Clothes Washer Medical Gas Water Heater Other: Sink (Service/Bar/Mop/etc.) Other: ACKNOWLEDGEMENT. 1 have reviewed ihis application and confirm the information contained herein is true and co�rect. Work done pursuant to this permit must comply wdh 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 Bui/ding Official before being authorized under any circumstance. 1 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 i827 RCW and 296.200A WAC. City of Everett Official Use Only �,^ � � / � P � � PERM T � lJ UU( ( � Date (Revised 10/12/2015)