10617 ROSEWOOD AVE 2022-01-25 - Laserfiche WebLink

PERMIT APPLICATIOilli IIla BUILDINOMECHANICAL / PLUMBING / SIGN , PRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (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:10617 Rosewood Ave, Everett Wa, 98204 PROPERTY TAX#:00552300301704,1705 LEGAL for new construction: Short Plat/subdivision Rancho Intercity BLK 03 Lot No.17,18 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Paul Kukhotskiy TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 132 116th Place SE CITY Everett STATE Wa ZIP 98208 OWNER PHONE: 425-737-7054 OWNER EMAIL:MAGICHARDWOOD1 @GMAIL.COM CONTRACTOR NAME:N/A CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: oo tt / CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):li`GO 1 f tL PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-737-7054 Paul Kukhotskiy CONTACT EMAIL:MAGICHARDWOOD1@GMAIL_COM BUILDING INFORMATION t� - �bn ,s Existing Use of Building:8irlgte'1=z+milY N/ Contract Price of Work: $ t flb�. ✓ Proposed Use of Building:L4144i-Fttmi}Y ''. ty ( Y" Heat Source: ❑Gas DElectric ❑Other_ BUILDING USE: ❑SFR ❑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: Clearing and grading for construction of a new duplex, an associated driveway, and drainage improvements. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C-Air Handling Units Gas Piping _ ackflow Preventer(Inside Bldg) 4 Shower,Tub,or Combo Boiler 2 Gas Range' 2 Clo es Washer Sink-Commercial(3-comp,prep,floor) 2 Clot Dryer Heat-Pump&Ductless 2 Dishes ar 12 Sink-Residential(kitchen,bath,bar) Duct Systern(Remodel) 2 Refrigeration Drinking Fountain 2 Sink-Utility,laundry,mop _Exhaust Fans(Residential) Commercial Ventilation Floor Drain _ 6 Toilet Exhaust Hood(Type I) ' . (Not Heat/AC system) _Hose Bibb Urinal Exhaust Hood(Type II) 2 -.'Water Heater Interceptor-Grease - Waste/Water Piping Repair Exhaust Hood(Residential) Stove Interceptor-Sand/Oil 2 Water_5ervice(behind meter) 2 Forced Air Systems Other: Medical G s' Water Valves or Fixtures Gas Fireplace/InserULog 7 Roof sins 2 _Water Heater SPRIN�4CER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppressi n 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 _.---.��'eSS -l1, 8 -(`t- ae PERt, N. O- 02E6 Owner other' ec -gent Signature Date (Revised 10/10/2018)/ �• Q/Z)