10030 HOLLY DR 3 BLDG 4 2022-08-17

NMI • PERMIT APPLICATION• BUILDING / MECHANICAL / PLUMBING /SIGN / SPRINKLER / DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I F - 857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT ITE INFORMATION PROJECT SITE ADDRESS: 10030 HOII rive #43 Ev rett, Wa 98204 PROPERTY TAX#: 00858500404300 LEGAL for new construction: Short PlaUsubdivi ion SEE 1 1 ACHED Lot No. (attach copy of long legal description) CONTACT INFORMATION , OWNER NAME: Marisa Ottinger TENANT BUSINESS NAME(Commercial): N.A. OWNER MAILING ADDRESS: STREET 10030 Holly Drive #43 cir Everett STATE WA ZIP 98202 OWNER PHONE: (425) 931-2185 OWNER � / EMAIL:� Marisa.Ottinger@Yahoo.com CONTRACTOR NAME: Clete Messerly 0A, -� V V �. C tA_2 CONTRACTOR ADDRESS: STREET P.O. Box 306 cm, Skykomish STATE WA ZIP 98288 CONTRACTOR PHONE: (406) 390-3676 CONTRACTOR EMAIL: CXM82O©gmail.com CONTRACTOR LICENSE#(REQUIRED):CLETEMC898CD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 55523 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR O OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE: (360) 563-1032 S+L Architects, Lynn Goto CONTACT EMAIL: Lgoto@sandlarchitects.com BUILDING INFORMATION r Existing Use of Building: Contract Price of, ork: LA�Sr, \ 5 ,A Proposed Use of Building: Heat Source: Li Gas ❑Elec is 00th BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: -UUo mercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 3 CR '4— (-1 l' 4 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 Backflow Preventer(Inside Bldg) Shower,Tub, ombo Boiler Gas Ran Clothes Washer Sink-Co ercial(3-comp,prep,floor) Clothes Dryer He ump&Ductless Dishwasher Si esidential(kitchen,bath,bar) Duct System(Remodel) efrigeration Drinking Fountain ink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain ,. Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb . Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Resi ntial) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Syst s Other: Medical Gas Water Valves or Fixtures Gas Fireplac nsert/Log Roof Drain Water Heater SPRIN R/SUPPRESSION SYSTEM Sewa 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.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. f City of Everett Official Use Only ( U - /5 ,),6, PE # Q - �2 J wner/Aµ4 orized Agent Sigrlat re Date (Revised 10/10/2018) '/2_