2324 ROCKEFELLER AVE 2017-10-25 - Laserfiche WebLink

PERMIT APPLICATION BUILDING I MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8890 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I wvw.everettwa.gov/permits (�Irae or Clack Irak.®rrly.Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 0-3a"+ IW PROPERTY TAX#: Oa 119 l oZ(06 LEGAL for new construction: Short Plaf/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (,�rnS S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY p�V e t STATE ZIP g I OWNER PHONE: 4 D �O -- Lo OWNER EMAIL: CONTRACTOR NAME, C UCr GR86AJ 5 T-al(r `7f(CLT 04trA-c_ CONTRACTOR ADDRESS: STREET 21`-)-lD� _ PWI" AQ� CITY �✓UCsY[�V r { STATE w.� ZIP lso0 CONTRACTOR PHONE: �25-2�2'�JII CONTRACTOR EMAIL: I rs h.p_ 0OSSMVVrJ .may) CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): t3 t, PRIMARY CONTACT: ❑OWNER &CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 475-_ZS21--50/ l�v� ��Y IIJI YLP1 CONTACT EMAIL: `eS e es sry-)v/a BUILDING PERMIT APPLICATION Existing Use of Building: `' 1 Contract Price of Work:$ S 30 Proposed Use of Building: Heat Source: Gas ❑Electric ❑Other Building Type: SFR-Detached ❑SFR-Attached []Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: add ©v4d cx*- hu(0 pury-) p ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION _ Type of Project: _New_ Addn Alteration _Repair Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units I Heat Pump IToilet 113ackflow Preventer(Inside Bldg) Forced Air Systems I Unit Heater 113athtub JUrinal Gas Piping Boiler Lavatory(Wash Basin) IlDrinking Fountain Water Heater Refrigeration IShower I Floor Drain Gas Fireplace Wood Stove Kitchen in &Disposal Grease Trap Gas Range Ducting IDishwasher IRoofDrains Clothes Dryer Hookups Other: IClothes Washer I Medical Gas Range Hood Iwater Heater Other: Exhaust Fan 1SInk(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSiON SYSTEM Number 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 locallaw.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized In writing from the Building Official before being authorized 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 I comply with the State Contractors Law 98.27 RCW and 296.200A WAC City of Everett Official Use Only Aidds Nell- [M��091 O�� O er/Authorized Agent Signat a Date (Revised 5/20/2016)