3406 ROCKEFELLER AVE 2018-02-23 - Laserfiche WebLink

477- PERMIT APPLICATIOr! BUILDING / MECHANICAL /PLUMBING /SIGN /SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwagov I www.everettwa.govipermits (Blue or Black Ink Only Please) �y ,( ,l'-l/PROJECT SITE INFORMATION PROJECT SITE ADDRESS: -3 ltD(ci 7\4DCV— :CCPROPERTY TAX#: MLO 82 0 Li '- LEGAL for ne::j construction Short Plat subdivision Lot No (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: h OV Cl-NC-1--- I�,U j TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Z3I(7� FCkli• tti2X- A `, , CITY ZN Y/'rt"7T ST,.TE zP �l CJ til✓I OWNER PHONE: 4 2S S"3 C 1-e12) OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY ST=TE -1P CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REOe'IRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: XOWNER 0 CONTRACTOR 0 OTHER :'.ease Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of BL,iicing: Contract Price of Work: $ [MD Proposed Use of Bui!oing: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detacreo ❑SFR-Attached I Duplex ❑Muiti-Famiiy-#of Units: ❑Commercial ❑industrial Type of Project: ONew DAddition ❑Remodel ❑Repair(�❑T.i. ❑Sign ❑Sprinkler ❑Demolition^ ❑Change of Use 1, CNDkj.eDESCRIPTION O ��} w '3 ` 1 1- 4-e.,\\ C.Y\S ( '(�Q lC•�Q_ - -o t le-k Isla we- s 1 S IY``L,� ASSOCIATED BUILDING PERMIT#(if appsicabie): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New _ Addn L.Alteration _Repair Type of Project: .'KNew _Addn _Alteration 'SRepair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of Lisr of Fixtures Fixtures Fixtures Fixtures Fixtures A C–Air Handling Units -eat Pump -7,- Toilet Backfiow 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 f • Clothes Dryer Hookups Other: _ Clothes Washer kledical Gas _ j Range Hood /- "Dater Heater Other: _ Exhaust Far .1, j Sink(Ser.ice.BarlMopietc.) Other: SPRINKLER / SUPPRESSION SYSTEM _Chemical or Water I No.of Heads ACKNOWLEDGEMENT:I have revie wed ties applicat-on and confirm the informavon 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, and!coin ly with the State Cont ors a 18.27 RCW and 296.200A WAC. City of Everett Ofc,a:Use Only e ]� , PE�2MIy.# )„.6 ,. c --------- I • — �' I .2-0—[ — 003 Owner/Authorized Agent S ature) Date (Revs` ed 9./23/2016;