2113 ROCKEFELLER AVE 2018-02-23 - Laserfiche WebLink

PERMIT APPLICATION BUILDINC 1 MECHANICAL/ PLUMBING /SIGN / itINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) hike SITE INFORMATION 2 PROJECT SITE ADDRESS: .1/3 R ereh//iiv nye. ,FWr4 h'j4 Qr PROPERTY TAX#: Oa y3 q/4/3 F00 602„ •LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 4Q' gtjrl 5'r A/f f` TENANT NAME(if Commercial): OWNER MAILING ADDRESS: srsr r T / (It 5a frfa S sIle 4441 k (f 4'boiee) 27 f 3 ear r�e/".� M-V�, I✓ Cd iY e e/e STATE ja J/.' 7IP Qde20 1 OWNER PHONE: 2O , 6,7 g. '77952 OWNER EMAIL: MATE s&f r rgbAH&rz. . (O Mei CONTRACTOR NAME: 5C' F A//A CONTRACTOR ADDRESS: STREET CITY S IA I L ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: -CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: I1:146WNER 0 CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: Na S{rCONTACT PHONE: 206. �p?D, F9,5?. '9�f CONTACT EMAIL: Am-7x5e fel' - oxr,h cool. BUILDING PERMIT APPLICATION /� p / Existing Use of Building: 'E'er;atm cc- GYM aa.n{r N//T Contract Price of Work:$ \/', IOD Proposed Use of Building: Q'Sidryl!{ Gf 0.(vk?1 Heat Source: ❑Gas (1eEectric lather_____________ Building Type: 11:16FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ommercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel QRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: C7u){1 - ra04'7 ova,- an( lay-tY o(Ach `rapt 5 gi (/ti0t'fl7 " 4r`a � /wo 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 #of List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan - Sink(Service/Bar/Mop/etc_) Other: SPRINKLER I SUPPRESSION SYSTEM Chemical or Water INo.of Heads ACKNOWLEDGEMENT:1 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 local law. 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 I am authorized by the owner of this property to perform the work for which application is made. and I comply with the State C ntrac.rs Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only r,, e PERM Owner/Authorize - gen lgnatu - Date (Revised 9/23/2016)