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® PERMIT APPLICATION <br /> IC <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:7018 BEVERLY BLVD, EVERETT, WA 98203-4940 PROPERTY TAX#:00392800100703 <br /> LEGAL for new construction: Short Plat/subdivision D-03 Lot No.2 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Pavel Svetleachni TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 16420 Spruce Way, Unit A4 <br /> cry Lynnwood STATE WA ZIP 98037 <br /> OWNER PHONE: (206) 940-5603 OWNER EMAIL:pavelsvet@gmail.com <br /> tr <br /> CONTRACTOR NAME: OW (- 2--- <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:(206) 940-5603 <br /> Pavel Svetleachni CONTACT EMAIL:pavelsvet@gmail.com <br /> BUILDING INFORMATION (AAExisting Use of Building: Contract Price of Work:$ <br /> Proposed Use of Building:Single Family Home Heat Source: ElGas DElectric ❑Other <br /> BUILDING USE: ElSFR ❑Townhouse Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ElNew ❑Addition ❑Remodel El Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Building of a new single family home. Includes all required work, grading, foundation, framing, roofing, <br /> HVAC, Plumbing, fire suppression, Electric, finish interior/exterior, hard surfaces and landscape. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): (-e-E U !„/` G-- —oLa4d-i.- \ <br /> MECHANICAL PERMIT APPLICATION,, PLUMBING P RMIT APPLICATION (,,9 _, <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count Lis!of Fixtures <br /> 1 A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) 4 Shower,,,Tub,or Combo <br /> Boiler Gas;Range 1 Clothes Washer Sink7.Commercial(3-comp,prep,floor) <br /> 1 Clothes Dryer 1 Heat Pump&Ductless 1 Dishwasher 7 Sirik-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) , Refrigeration Drinking Fountain 2 Sink-Utility, laundry,mop <br /> 5 Exhaust Fans(Residential) Commercial Ventilation Floor Drain 4 Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) 2 Hose Bibb r, Urinal <br /> Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> 1 Exhaust Hood(Residenfi l) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> 1 Forced Air Systems r, Other: Medical Gas Water Valves or Fixtures <br /> 2 Gas Fireplace/Inserf/PLog Roof Drains 1 Water Heater <br /> SPRINKLER SUPPRESSION SYSTEM Sewage Eject or Sump Pump _ 1 Other: Pot filler over range <br /> Water Suppression Systn No.of Heads i Dram pan for clothes washer <br /> Chemical Suppression System No.of Heads <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> P 'v T# <br /> 24; a-C ---. d 6 .2 S-• 2 02 a 1 2Ci) ..-00+ <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />