2925 ROCKEFELLER AVE 2018-07-19 - Laserfiche WebLink

II II''II''II PERMIT APPLICATIIM 411111//it- BUILb1NL /MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES ' y f 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits i(Blue or B1"ack tnl [ly Please) %,"" :"PROJECT SIT INFO FA;TION PROJECT SITE ADDRESS:2925 + Ste Rockefeller Ave PROPERTY TAX#: 00439168500300 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTAGT,INFORMATION OWNER NAME: Snohomish County TENANT NAME(If Commercial): N/A-Abandoned OWNER MAILING ADDRESS: STREET 3000 Rockefeller Ave; M/S 404 CITY Everett STATE WA ZIP 98201 OWNER PHONE: 425-388-3154 OWNER EMAIL: Jeffery.Hencz@co.snohomish.wa.us CONTRACTOR NAME: FORMA Construction Co. CONTRACTOR ADDRESS: STREET PO Box 11489 cry Olympia STATE WA ZIP 98508 CONTRACTOR PHONE: (206)626-0256 CONTRACTOR EMAIL: LoriN@formacc.com CONTRACTOR LICENSE#(REQUIRED): FORMACC878OR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):054396 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (206)475-0792 Lori Nicholson CONTACT EMAIL: LoriN@formacc.com BUILDING PERMIIT APPLICATION , _ . Existing Use of Building: Abandoned Commercial Contract Price of Work: $420§41' $SCJ, 41E.1. 11 Proposed Use of Building:Demolition Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: j7_ICommercial 0 Industrial Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler 4Demolition ❑Change of Use DESCRIPTION OF WORK: Demolish building in its entirety; provide compacted fill at demo sites; existing grades and drainage to be unchanged 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 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' 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 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 Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PER IT# 2-00 2 (?(Dqiit. a t 621 oq1�1 5 L Jw) Owner/Authorized Agent Signature Date (Revised /23/2016)