1617 127TH PL SE 2022-05-11 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (477P)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:1617 127th PL SE, EVERET WA 98208 PROPERTY TAX#:00571600000600 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: DANIEL S MERY TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1617 127th PL SE CITY Everet STATE WA ZIP 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ()IJ/1/Y" CONTRACTOR ADDRESS: STREET ' CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR D OTHER(Please Specify) DESIGNER CONTACT NAME: CONTACT PHONE:206-775-1471 ERMIAS KOTU CONTACT EMAIL:eMD.designpractice@gmail.com BUILDING INFORMATION Existing Use of Building: Residential Contract Price of Work:$$16,000.00 Proposed Use of Building: Heat Source: ❑Gas DElectric DOther BUILDING USE I=ISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ®New ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Sign LISprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Converting existing family room to a addii�tional 3 bedrooms. Also in adding a new deck on the back of side of the house. ��/,y^^ O 15.1 / p /1 ASSOCIATED BUILDING PERMIT#(if applicable): (�!/VY MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture List of Fixtures Fixture List of Fixtures Count List of Fixtures Count List of Fixtures Count Count N/A NC—Air Handling Units N/A Gas Piping N/A Backflow Preventer(Inside Bldg) N/A Shower,Tub,or Combo N/A Boiler N/A Gas Range N/A Clothes Washer N/A Sink-Commercial(3-comp,prep,floor) N/A Clothes Dryer N/A Heat Pump&Ductless N/A Dishwasher N/A Sink-Residential(kitchen,bath,bar) N/A Duct System(Remodel) N/A Refrigeration N/A Drinking Fountain N/A Sink-Utility,laundry,mop NIA Exhaust Fans(Residential) Commercial Ventilatior N/A Floor Drain N/A Toilet N/A Exhaust Hood(Type I) N�A (Not Heat/AC system) N/A Hose Bibb N/A Urinal N/A Exhaust Hood(Type II) N/A Water Heater N/A Interceptor-Grease N/A Waste/Water Piping Repair N/A Exhaust Hood(Residential) N/A Wood Stove N/A Interceptor-Sand/Oil N/A Water Service(behind meter) N/A Forced Air Systems N/A Other: N/A Medical Gas N/A Water Valves or Fixtures N/A Gas Fireplace/Insert/Log N/A N/A Roof Drains N/A Water Heater SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump N/A Other: Water Suppression System N/A No.of Heads N/A Chemical Suppression System N/A No.of Heads N/A 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 PE # -_- r/Authoriz Agent Al_ Date (Revised 10/10/2018) D2A bili-' OC) [ //01127 ----- 9