1922 112TH ST SW 2022-05-02 - Laserfiche WebLink

PERMIT APPLICATIO 12 BUILDING1ECHANICAL/ PLUMBING/SIGN MP RINKLER/ 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.everetiwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1922 112th st sw everett Wa 98204 PROPERTY TAX#:00537900004402 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: kelvin kelting TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET18710 62nd pI west cry Iynnwood STATE wa ZIP 98037 OWNER PHONE:425-361-3424 OWNER EMAIL:keIvinkelting@gmail.com CONTRACTOR NAME: na 0C-0 U `"� CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: El OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: single familly Contract Price of Work:$55000.00 .... . Proposed-Uke`ofiBuilding:"dou1able famill Y _ _ Heat-Source: OGas ❑Electric DOther BUILDING USE: OSFR ❑Townhouse ✓❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commer I ■Accessory Structure Type of Project: ❑✓New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demoli IP i1�-�`• g f Use DESCRIPTION OF WORK: removal of exciting moble home Bacl-b4liki--RWALGILI1310.Y.- . g 174- `� kr- A" c ? ASSOCIATED BUILDING PER�P1ef o� OZ,J MECHANICAL PERMIT APPLICATION PLUMBING PERMIT A '"' Fixture Fixture Fixture Fixture erg t x ' Count List of Fixtures count List. Fixtures Count List of Fixtures Count ii es NC—Air Handling Units X Ga -Iping x Backflow Preventer(Inside Bldg) X Shower,Tub,o ombo Boiler X =-s Range X Clothes Washer Sink-Co rcial(3-comp,prep,floor) X Clothes Dryer Heat Pump&Ductless X Dishwasher X Sin esidential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain X ink-Utility,laundry,mop X Exhaust Fans(Residents Commercial Ventilation x Floor Drain Toilet Exhaust Hood(Type (Not Heat/AC system) x Hose Bibb X Urinal Exhaust Hood(T •e II) X Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hoc). -esidential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air'. stems Other: hydronic Medical Gas x Water Valves or Fixtures Gas Fir:.ace/Insert/Log X Roof Drains X Water Heater SPRINKLER I SUPPRESSION SYSTEM Sewage jector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System I No.of Heads ACKNOWLEDGEMENT.:!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 � J /6-6-�2o P Soo - oo \ Owner/Authorized Agent Signature Date (Revised 10/10/2018) iz_