2107 ROCKEFELLER AVE 2017-07-26 - Laserfiche WebLink

09/29/2016 THU 3: 43 FAX 425 252 1666 CM Heating U002/004 PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING I SIGN / SPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)426-267-8610 FAX 426257.8867 1(I;)everetteps9everettwo.gov I wvrw.evorettwa.gov/permits f ki'o pr 15Iack'Ink Only please PRbJLCT $ITE II4FOkMATIQN PROJECT SITE ADDRESS: V � PROPERTY TAX M. LEGAL for new construction; Short Plet/subdlvlslon Lot No. (attach copy of long legal dascrlptlon) 00A& INFORMATION OWNER NAME: TENANT NAME If Commerclal): OWNER MAILING ADDRESS: STREZT CJK� CITY grgT[: � - zip OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: y CONTRACTOR ADDRESS: STR�cT � W cn-r STATE �� 2IP tV1 CONTRACTOR PHONE: 14 Q CONTRACTOR EMAIL: Ltl CONTRACTOR LICENSE#(REQUIRED): [.1 ' -n d n CITY OF EVERETT BUSINESS LICENSE if(REQUIRED): PRIMARY CONTACT; ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: 1 CONTACT PHONE: 42S a t CONTACT EMAIL: �tinc ( m r �r °irr p I. r,a,N EXIStIng Use of Bulldin Contract Price of Work: $ Pro osed Use of Buildln : Heat Source: ❑Gas ❑Efectrlc ❑Other Building Typo: ❑SFR-Detached OSFR-Attached L-]Du lax QMultl-Farnll -#ofUn[ts: ❑Commercial ❑Industria[ T e of Project: 0ew ❑Addition ❑Remodel ❑Re air ❑T.I. ❑Sin 135 rinklor ❑Demoflilon ❑Chan e of UBe DESCRIPTION OF WORK: WI 1ti� ASSOCIATED BUILDING PERMIT# If applicable): #T.�t�N. Type of Project: _Naw _ Addn —Alteratiotl Repair Type of Project: New __\ddn _Alteration Repair # of List o/Flxfuras #of >1Xt of Flxfunes List ofFixfuras Flxtuf s List of List #of List ofFixturws Fixtures A/C—Alr Handlln Units Heat Pump Tollet Backflow Preventer Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas PIpIng Boller Lavatory(Wash Sesln) Drinking Fountain Water Heater Refrl eratlon Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drain9 Clothes Dryer Hookupa Other: Clothes Washer Medical Gas Range Hood Wafer Heater Other: Exhaust Fan Zink Service/Bar/Mo /etc, Other: Number of Hee a ACKNOWLEDGEMENT.1 have reviewed this application and confirm the informaflon confeined hareln is true and correct. Work done pursuant to this permlt must comply with currant federal,state,and local low. The granting of a perm!(only authorizes approved work and no deviations therefrom,Deviations must tlrsi be outhcrized in writing from the Building Officlel before being euthorized undar any circumstance.1 em the owner, or I am authorized by the owner of this property to perforin the work for which application is made, and I comply with the State Conlraclors Law 18.27 RCW and 286.200A WAC. Cly of Everett Oft]cisl Use Only (�f`•�.� I�� PE MI 1;< Ownor/Authorlxed Agent 81pn trere `'�Date (Revised 15/2412016)