1717 ROCKEFELLER AVE 2019-04-29 - Laserfiche WebLink

PERMIT APPLICATION( "ow BUILDING/MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION 400 ___ 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) . : . PROJEdT-LITE I/NFORIVIATION • . PROJECT SITE ADDRESS: /I/if /206/6-- -ctjG 1`(c (PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long regal description) • . _.CONTACT INFORMATION . . . " . • • • • • OWNER NAME: LA/A 04 44_6 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET j 7/7 /e-U /ii•f,'!' .. CITY STATE (N4 ZIP A7.8`wc-- OWNER PHONE: �� ] OWNER EMAIL: .w_..,. 1J..",..6rra-rI-�,,,.- G?$tcerWL6 'c-,...,..._..,..... ..r,.....•....,..,•..,_.._. .., CONTRACTOR NAME: (- VC, CONTRACTOR ADDRESS: STREET S-120 (ACI P.C. AU CITY i UCtetsrr STATE LA)4— ZIP et 432®/ CONTRACTOR PHONE: 4'26-°_5 2.." I/LJ • CONTRACTOR EMAIL: /44/4LI a f,c varAel= CONTRACTOR LICENSE#(REQUIRED): COGY24.5 j o2Zo T' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)• 0 6-7 el.-5- • PRIMARY CONTACT: 0 OWNER &CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4 25-2-5-2-->//9 CONTACT EMAIL: • EUILDINCa PERMIT APPLICATION - • Existing Use of Building: NO Ca 1O Contract Price of Work:$le/yi,®60 Proposed Use of Building: Ot)c, abblib Heat Source: Was 0Electric ['Other Building Type: ❑SFR-Detached CISFR-Attached ❑Duplex ©Multi-Family-#of Units: tICommerciai ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel %Repair CIT.I. OSign CDSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: r 1 ,v6 /27V. A � e' t .g77no, i4 ,0-6.44,14, /g�/d i- /,� CGI 4 ctitl ASSOCIATED BUILDING PERMIT#(if applicable): : .•MECHANICAL.PERMIT—APPLICATION 1 ' - PLUMBING PERMIT APPLICATION : - Type of Project: _New Addn Alteration f 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 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/S,UPPRRESSiON 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. V/ � / City of Everett Official Use Only I(Th 0 0 //V/!r PEI�VI�/i�#‘ ,zot4 — Owner/Authorized • gnature Date (Revised e�rd/5/20/2016) CD