1712 19TH ST 2021-09-02 - Laserfiche WebLink

PERMIT APPLICATI111 / PLUMBING / SIGN PRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASH INGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1712 19th Street PROPERTY TAX#: 00437038003101 LEGAL for new construction: Short Plat/subdivision Block 380 Lot No.32 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Evergreen Property Renewal LLC TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET PO Box 130 cry Arlington STATE WA ZIP 98223 OWNER PHONE: 425-343-4562 OWNER EMAIL:northvlew1017@USa.com CONTRACTOR NAME:Rldgeland Custom Homes LLC CONTRACTOR ADDRESS: STREET PO Box 130 Arlington STATE WA ZIP 98223 CONTRACTOR PHONE:425-343-4562 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):RIDGECH851 QC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-343-4562 Dennis Wriglesworth CONTACT EMAIL:northview1017©usa.com BUILDING INFORMATION Existing Use of Building:Single Family Home Contract Price of Work: $80,000 Proposed Use of Building:Single Family Home Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: USER ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑✓Remodel ✓❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: New Roofing, Windows and Siding, New Electrical, Plumbing and Heating System. Complete Interior Finish. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count t List of Fixtures Count List of Fixtures 1 A/C—Air Handling Units Gas Piping Backflpw Preventer(Inside Bldg) 4 Shower,Tu r Combo Boiler Gas Range 1 Clothes Washer Sink- mercial(3-comp,prep,floor) 1 Clothes Dryer Heat Pump&Ductless 1 Dishwashef 6 WA-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain i-� Sink-Utility,laundry,mop 4 Exhaust Fans(Residential) Commercial Ventilation Floor Drain „% 3 Toilet Exhaust Hood(Type I) (Not Heat/AC system) 2 Hose Bibb Urinal Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease Waste/Water Piping Repair 1 Exhaust Hood(Residential) Wood Stove Interceptor-Sand/D Water Service(behind meter) Forced Air Systems Other: Medical Gas �'' Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Dr \1 Water Heater SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump \ Other: Water Suppression System No.of Heads Chemical Suppression System 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. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature Date (Revised 10/10/2018)