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• PERMIT APPLICATION • <br />EVERETT <br />WASH I NC TAN <br />BUILDING / MECHANICAL I PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(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: 71 0 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: SIR .ET71 0 90th PI SE <br />CITY Everett ',T\TE WA z,P 98208 <br />OWNER PHONE: 1OWW <br />EMAIL: <br />CONTRACTOR NAME: Un n / <br />CONTRACTOR ADDRESS: 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 />Martin Reimers, AIA <br />CONTACT PHONE:425.377.8786 <br />CONTACT EMAIL:mreimers@conceptarchitecture.com <br />BUILDING INFORMATION <br />Existing Use of Building:SFR <br />Contract Price of Work: $25000 <br />Proposed Use of Building:SFR / Adult Family Home <br />Heat Source: E]Gas []Electric ❑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 Use <br />DESCRIPTION OF WORK: Convert garage to living space and renovate lower level to create new adult family home. <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 Fixture <br />Fixture <br />Coun <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/ Air Handling Units <br />Gas Pi <br />kflow Preventer (I,iside Bldg) <br />1 <br />Shower or Combo <br />Boiler <br />ange <br />1 <br />Clothe asher <br />-Commercial (3-comp, prep, floor) <br />1 <br />Clothes Dr. <br />Heat Pump&Ductless <br />1 <br />Dishwasher <br />1 <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (R odel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />2 <br />Exhaust Fans (Residenti <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain _ <br />1 <br />Toilet <br />Exhaust Hood (T I) <br />Hose Bibb, ----Urinal <br />Exhaust Ho Type ll) <br />ter Heater <br />Inter or -Grease <br />Waste/Water Piping Repair <br />1 <br />Exhaus ood (Residential) <br />Wood <br />I erceptor-Sand/Oil <br />W Service (behind meter) <br />For d Air Systems <br />Other: <br />Me ical Gas <br />Water V s or Fixtures <br />as Fireplace/Insert/Log <br />Roof Drains <br />1 <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />iSewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />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 befpj being authorized under any circumstance. I am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and I comply witkfhd State Cont rs La 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />11/19/19 PERMIT <br />Agent Signature Date (Revised 1011012018) <br />i L., <br />