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. PERMIT APPLICATIO* <br />BUILDING /MECHANICAL /PLUMBING /SIGN /SPRINKLER /DEMOLITION <br />EVERETT 32CITY OF EVERETT PERMIT SERVICES <br />00 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS. 1700 ENGLAND AVE <br />PROPERTY TAX #: 005549401300200 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: MEHRSADEH ABOOLHASSAN TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET 1700 ENGLAND AVE <br />CITY EVERETT STATE WA ZIP 98203 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAM TBD <br />CONTRACTOR ADDRE STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />LUIS F. SIALER <br />CONTACT PHONE: 425 877 7377 <br />CONTACT EMAIL: sialerdesign@gmail.com <br />BUILDING INFORMATION <br />Existing Use of Building: R-3 <br />Contract Price of Work: $ 25 <br />Proposed Use of Building. R-3 <br />Heat Source: OGas Electric ❑Other <br />BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ❑New ✓❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sin ❑Sprinkler ❑Demolition ❑Chan a of Use <br />DESCRIPTION OF WORK: NEW 365 SF UPPER FLOOR ADDITION )NO CHANGE FOOTPRINT,/REMOVE SOME INTERIOR <br />WALLS TO OPEN UP KITCHEN/GREAT ROOM <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink-Commercia[- �omp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless-- <br />Dishwasher <br />Sink -Rest, teal (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration ' <br />Drinking Fountain <br />Sin ility, laundry, mop <br />Exhaust Fans (Residential) <br />Commer . ventilatio <br />(N-i4eat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Inse og <br />Roof Drains Z <br />Water Heater <br />SPRINKLE SUPPRESSION <br />SYSTEM <br />Sewage Ej or or Sump Pump <br />Other: <br />Water Suppression >SKtem <br />No. of Heads <br />Chemical Suppres ion System <br />No. of Heads <br />ACKNOWLEDGEMENT. / 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 u er any circumstance. I am the owner, or / am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors L4i 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PER)n� _ (D�'-A <br />Date (Revised 1011012018) <br />