1925 73RD ST SE 2021-12-22 - Laserfiche WebLink

PERMIT APPLICATIO BUILDINCOECHANICAL / PLUMBING / SIGN�RINKLER / DEMOLITION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1925 73rd street SE Everett, WA 98203 PROPERTY TAX #: 28050800204000 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Wanlbu Ann NJUguna TENANT BUSINESS NAME (Commercial): OWNER MAILING ADDRESS: STREET 1925 73rd street cITy Everett STATE WA ZIP 98203 OWNER PHONE: 678-856-0191 OWNER EMAIL: CONTRACTOR NAME: Homeowner CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR O OTHER (Please Specify) Designer CONTACT NAME: Carmelo N. Laviste CONTACT PHONE: 206-6832395 CONTACT EMAIL: carmelolavisTiPKpail.com BUILDING INFORMATION Existing Use of Building: Single-family residence Contract Price of Wo k: $ 2goiLfo La q CA L Proposed Use of Building: Adult -Family Home Heat Source: OGa Electri ❑Other BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑C mercial ❑Accessory Structure Type of Project: ❑New ❑✓ Addition ❑✓ Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Count List of Fixtures Fixture count List of Fixtures Fixture Count List of Fixtures Fixture Count List of Fixtures A/C — Air Handling Units Gas Piping Backflow Preventer (Inside Bldg) 1 Shower, Tub, or Combo Boiler Gas Range Clothes Washer $irjk-Commercial (3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink -Residential (kitchen, bath, bar) Duct System (Remodel) 1 Refrigeration Drinking Fountain Sink -Utility, laundry, mop 1 Exhaust Fans (Residential) Commercial Ventilatior (Not Heat/AC system) Floor Drain Toilet Exhaust Hood (Type 1) Hose Bibb Urinal Exhaust Hood (Type II) Water Heater Interceptor-Greasenr , Waste/Water Piping Repair Exhaust Hood (Residential) Wood Stove Interceptor-Sao0il Water Service (behind meter) Forced Air Systems Other: Medical G,3,9 Water Valves or Fixtures Gas Fireplace/Insert/Log Roof ains Water Heater SPRINKLER / SUPPRESSION SYSTEM wage Ejector or Sump Pump Other: Water Suppression System I INo. of Heads Chemical Suppression System I I No. 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. 7, Owner/Authorized Agent Signature City of Everett Official Use Only Date (Revised 1011012018)