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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 />(P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa gov/permits <br />®1w a Black Isle Only Pls"0) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 10225 1ST DR SE, EVERETT, WA 98208 PROPERTY TAX #:00396900001202 <br />LEGAL for new construction Short PlaUsubdivision Lot No. 12 (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: KALILU KONTEH FATOUMATA TENANT BUSINESS NAME (Commercial): <br />OWNER MAIUNG ADDRESS: sTREEr 10225 1 ST DR SE, <br />utv EVERETT STATE wa zip 98208 <br />OWNER PHONE: OWNER EMAIL: <br />CONTRACTOR NAME: OWNER <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE an, <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CI[TY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR El OTHER (Please Specify) _eMD Design Prartce <br />CONTACT NAME: <br />ErmiaS KOtU <br />CONTACT PHONE: 206-775-1471 <br />CONTACT EMAIL: emd.designpractice@gmail.com q <br />BUILDING INFORMATION <br />Eadstinq Use of Buitdl SFR <br />Contract Price of Worst: $ 20,000.00 <br />Proposed Use of Building: Lowe [ever to used for AFH <br />Heat Source: ❑Gas ElElectric 00ther <br />BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair RIT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: 1 ADDING GRAB BAR TO EXIST. BATHROOM <br />2. CONVERT PORTION OF THE GARAGE TO LIVING/SLEEPING SPACE FOR AFH <br />A&SOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />FlxLrre <br />t:nu r <br />List of Fixtures <br />ca.,rf <br />List of Fixtures <br />Facture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />_ <br />List o1 Fafttres <br />A/C - Air Handfing Units <br />Boiler <br />Clothes Dryer <br />Duct System (Remodel) <br />Exhaust Fans (Residential) <br />Gas Piping <br />Gas Range <br />Heat PumpBDuctless <br />Refrigeration <br />Commercial Ventilatior <br />(Not HeatiAC system) <br />Backfiow Preventer (Inside Bldg) <br />Clothes Washer <br />Dishwasher <br />Drinking Fountain <br />Floor Drain <br />Shower, Tub, or Combo <br />Sink -Commercial (3-comp,prep.foor) <br />Sink -Residential (kitchen,bath,bar) <br />Sink -Utility, laundry, mop <br />Toilet <br />Extraust Hood (Type 1) <br />Hose Bibb <br />Unnal <br />i <br />Exhaust Hood (Type 11) <br />Exhaust Hood (Residential) <br />Forced Air Systems <br />Gas Fireplacellnsert/log <br />Water Heater <br />Wood Stove <br />Other; <br />Interceptor -Grease <br />Interceptor-Sand/Oil <br />Medical Gas <br />Roof Drains <br />WasteiWater Piping Repair <br />Water Service (behind meter) <br />Water Valves or Fixwms <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />sewage Ejector or Sump Pump <br />Other <br />Jlater Suppression System <br />Ctiemual Suppression System <br />No. of Heads <br />No. of Heads <br />it;r.rvuwLcc,ucnrcrvr: i have reviewed this aoplkatron and confirm the information contained herein is Irue and correct. Work done pursuant to this pem if must comFdy with <br />current iaderal, state, and local few. The granting of a permit oMy autitcvizes approved work and no deviations therefrom. Deviations Trust first be authorized in writing from the <br />Budding Official before being authorized under any circumstance, t am the owner, or t ern aadhodzed by the owner of this property to perform the wol* for which application is made, <br />and f co>^Ff1' with the State Contrudors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Omcial usC.e % <br />-�-'l PERMIT # <br />+"�umarfkuthoed Agortt gtgnstitre Date <br />(Revisee rala2ofa) <br />(4 <br />