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PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />rPl 42.5-257-8810 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:710 90th PI Se <br />PROPERTY TAX #:00605900000500 <br />LEGAL for new construction: Short Plat/subdivision Emerson Park East Lot No.5 (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Gedyon Gezahegne and Emebet WOSene TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: S11EET71 0 90th PI SE <br />cITY Everett STATE WA z,P 98208 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME U-n <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: 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 />Martin Reimers, AAA <br />CONTACT PHONE:425.377.8786 <br />CONTACT EMAIL:mreimers@conceptarchitecture.com <br />BUILDING INFORMATION <br />Existing Use of Building:SFR lContract <br />II <br />Price of Work: 00 Y� 6Q OJ <br />Proposed Use of Building:SFR / Adult Family Home <br />Heat Source: E]Gas ❑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. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION of WORK: Convert garage to living space and renovate lower level to create new adult family home. <br />V y L" ° t —�v U�L� <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICAT ON <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 Pr nter (hiside Bldg) <br />1 <br />S wer, Tub, or Combo <br />Boiler <br />Gas Range <br />1 <br />Clothes Washer <br />ink -Commercial (3-comp,prep,floor) <br />1 <br />Clothes Dryer <br />Heat Pump&Ductless <br />i <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />2 <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Exhaust Hood (Type II) <br />1 <br />Water Heater <br />Interceptor -Grease <br />Waste/ r Piping Repair <br />1 <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service hind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fix s <br />Gas Fireplace/Insert/Log <br />I <br />I <br />Roof Drains <br />1 <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ej for or Sump Pump <br />Other: <br />Water Suppression System <br />I No. of Heads <br />Chemical Suppression System <br />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 bef5gj 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 wiKthl State Cc tr TsLa 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT <br />11/19/19 - <br />ed Agent Signature Date (Revised 1011012018) <br />M �0 01- oo <br />