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04-17 PERMIT APPLICATIO' <br /> BUILDIN( AECHANICAL I PLUMBING / SIGN , jPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2915 17th Street, Everett, WA 98201 PROPERTY TAX#: 00605400201100 <br /> LEGAL for new construction: Short Plat/subdivision Victory Add 002D-00 Lot No. 11 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Rachel Shapiro TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 18105 Sunset Way <br /> Edm-ors WA 98026 <br /> CITY STATE ZIP <br /> OWNER PHONE: 425.381.6648 OWNER EMAIL: shaprachel@gmail.com <br /> CONTRACTOR NAME: Owner preformed, see above data <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) Architect, (father of owner) <br /> CONTACT NAME: CONTACT PHONE: 425.778.5400 <br /> Tony Shapiro, architect <br /> CONTACT EMAIL: tonys@adshapiro.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: home Contract Price of Work: $ 25,000 <br /> Proposed Use of Building: home Heat Source: OGas ElElectric DOther <br /> Building Type: ®SFR-Detached 0 SFR-Attached 0 Duplex 0 Multi-Family-#of Units: ❑Commercial 0 Industrial <br /> Type of Project: ❑New DAddition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition El Change of Use <br /> DESCRIPTION OF WORK:Removal of dry rotted framing, replacement of GWB, bathroom update, plumbing fixture, supply and waste line <br /> replacement, new polypipe supply line from meter, repEacelr-else-a -ties-paiel,iftst-all-4-r4eu-aleerheaters,-rewife- 4tchen{bat Alex-atitlets: <br /> Replace existng exterior sheathing,water resistant barrier and siding with hardi panel bevel siding. <br /> Footprint of house is not changing. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn X Alteration X Repair Type of Project: _New _Addn X Alteration X Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump _ 1 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 1 Bathtub Urinal <br /> Gas Piping Boiler 1 Lavatory(Wash Basin) Drinking Fountain <br /> 1 Water Heater Refrigeration 0 Shower Floor Drain <br /> Gas Fireplace Wood Stove 1 Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting 1 Dishwasher Roof Drains <br /> 1 Clothes Dryer Hookups Other: 1 Clothes Washer Medical Gas <br /> 1 Range Hood • I1- WaterHeater-- / Other:l,.t,C1,D11 <br /> 1 Exhaust Fan 0 Sink(Service/Bar/Mop/etc.) Other: ff�� <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Chemical or Water No. 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 OnlyAD <br /> fu ��y � �� 14- Fl ) PERMIT# (� /� <br /> Owner u orized A ignbture Date (Revised 9/23/2016) <br /> l <br />