523 61ST ST SE 2022-08-12 - Laserfiche WebLink

• PERMIT APPLICATIO. BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASH I NGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:523 61ST ST SE PROPERTY TAX#:00579300202701 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ' CONTACT INFORMATION OWNER NAME: BRIAN BODGE TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET4679 ARBORS CIR crry MUKILTEO STATE WA ZIP 98275 OWNER PHONE:425-879-3437 OWNER EMAIL:brianbodge@msn.com CONTRACTOR NAME:OWNER CONTRACTOR ADDRESS: STREET4679 ARBORS CIR CITY MUKILTEO STATE WA ZIP 98275 CONTRACTOR PHONE:425-879-3437 CONTRACTOR EMAIL:brianbOdge@mSn.COM CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ID OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-879-3437 BRIAN BODGE CONTACT EMAIL:brianbodge@msn.com BUILDING INFORMATION ° Existing Use of Building:RESIDENTIAL S,L4 Contract Price of Work:$75,000 Proposed Use of Building:RESIDENTIAL S.tt, R Heat Source: DGas DElectric ❑Other BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New EIAddition ORemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Remodel existing single family residence. No increase in lot coverage. ADD from 576 RY Tb AooD THREe ,9'L /Wt, 1' d Two i3>4-�"//290.t4S 4-0d DEG . et/ /34c/L ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures CountList of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) 2 Shower,Tub,or Combo Boiler Gas Range 1 Clothes Washer Sink-Commercial(3-comp,prep,floor) 1 Clothes Dryer 1 Heat Pump&Ductless Dishwasher 2 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain 2 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(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) 1 Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains 1 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.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 n / Z��9 PERMIT#C( R67 fOO( wner/Authorize Agent Signature ( Date (Revised 10/10/2018)