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PERMIT APPLICATION■
<br /> "IPBUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/ DEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits
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<br /> I - ITE:I I 't0'iti ATION�. ,
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<br /> PROJECT SITE ADDRESS:2120 62nd St Se PROPERTY TAX#:00544900300500
<br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)
<br /> r. :.vnM r,1a. ..r, gar .. .. 40 I _, tAtr' F0:**11# O,a� '; 4 . .l#`M ...
<br /> OWNER NAME: Suzanne Zavetsky TENANT BUSINESS NAME(Commercial):
<br /> OWNER MAILING ADDRESS: sTREET2120 62nd St Se
<br /> cny Everett STATE Wa ZIP 98203
<br /> OWNER PHONE:425-244-6399 OWNER EMAIL:
<br /> CONTRACTOR NAME:Bath Plus Inc
<br /> CONTRACTOR ADDRESS: STREET 1427 130th Ave Ne
<br /> CITY Bellevue STATE Wa ZIP 98005
<br /> CONTRACTOR PHONE:425-229-3296 CONTRACTOR EMAIL:nick.sary@bath-plus.com
<br /> CONTRACTOR LICENSE#(REQUIRED) BATHPPI9O8Q4 CITY OF EVERETT BUSINESS LICENSE#(REQUI D) \
<br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:425-229-3296
<br /> Nick Sary CONTACT EMAIL:nick.sary@bath-plus.com
<br /> WExistin B t _ � � ���
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<br /> Existing Use of u�ld�ng:Residential Home Contract Price of Work:$ 1 ��
<br /> Proposed Use of Building:Residential Home Heat Source: ❑Gas lectric ❑Other
<br /> BUILDING USE: EISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure
<br /> Type of Project: ❑New Addition ✓❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of se
<br /> DESCRIPTION OF WO K: Turn an existing bathroom door into a pocket door, modify 2 other doorways into barn doors,
<br /> ASSOCIATED BUILD! ERMIT#(if applicable): I
<br /> ,. , ... ERMIT APPII.(CA QN.`,,, . "'" k •P .WMII3 NGPER„s -04k U,t►„A.TION. . a
<br /> IIIIE�H, 1,�CAL�P,., ., ,.,.
<br /> Fixture Fixture Fixture Fixture
<br /> List of Fixtures List of Fixtures List of Fixtures List of Fixture
<br /> Count Count Count Count
<br /> NC-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or . bo
<br /> Boiler Gas Ran" Clothes Washer Sink-Co -rcial(3-comp,prep,floor)
<br /> Clothes Dryer Hea mp&Ductless Dishwasher S'' 'esidential(kitchen,bath,bar)
<br /> Duct System(Remodel) frigeration Drinking Fountain Sink-Utility,laundry,mop
<br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet
<br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb . Urinal 1
<br /> Exhaust Hood(Type II Water Heater Interceptor-Grease Waste/Water Piping Repair
<br /> Exhaust Hood(R dential) Wood Stove Interceptor-San. #11 Water Service(behind meter)
<br /> Forced Air S ems Other: Medical G. Water Valves or Fixtures
<br /> Gas Fire ce/Insert/Log R.. %wins Water Heater
<br /> , 00, ,1 ' 00.01 SS S S1 EI 3' „ Sewage Ejector or Sump Pump Other:
<br /> Water Suppression System No.of Heads
<br /> Chemical Suppression System I INo.of Heads
<br /> 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 + '
<br /> 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
<br /> 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,
<br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC.
<br /> City of Everett Official Use Only
<br /> -------...,..e, Lt141___ PERM �C\C-)Li‘r' OS
<br /> O er/Authorized Agent Signature Date (Revised 10/10/2018)
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