9204 EVERGREEN WAY 2022-04-01 - Laserfiche WebLink

MIMS PERMIT APPLICATIOni / PLUMBING / SIGN /AJPRINKLER / DEMOLITION AERETT 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:9204 Evergreen Way PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Tuan Nguyen TENANT BUSINESS NAME(Commercial): Tuan Nguyen OWNER MAILING ADDRESS: STREET 9204 Everett Way CITY Everett STATE WA ZIP OWNER PHONE: 425-350-9002 OWNER EMAIL:tuan.mguyen craneae.COnl CONTRACTOR NAME:Hong Phan CONTRACTOR ADDRESS: STREET 3319 249th PL CITY Kent STATE WA ZIP 98032 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):HONGSGC825B5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 55121 PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR 0 OTHER (Please Specify) CONTACT NAME: CONTACT PHONE:206-227-2275 Hong Phan CONTACT EMAIL:HOngtphan@gmall.COm BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$$2500 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ESFR ❑Townhouse ❑Duplex i❑ADU JMulti-Family-#Units: ❑Commercial LlAccessory Structure Type of Project: LT New LAddition 1✓Remodel ❑Repair LT.I. -Sign CSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install one Exhaust fan 340CFM supply for 05 Manicure Table ASSOCIATED BUILDING PERMIT#(if applicable): B2104 07$ 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 Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp.prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility, laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) 01 (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/ 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.lam the owner, or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only I PERMIT# ( l / y Owner/Authorized Agent Signature ate (Revised 10/10/2018) 1 1