614 48TH ST SE 2023-05-23 - Laserfiche WebLink

PLSUIBING PERMIT APPLICAN EVERETT SUBMITTAL CITY OF EVERETT PERMIT SERVICES INSTRUCTIONS: Drop off hard copy completed paper application to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION: (P)425.257.88101(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 614 48TH STREET SE PARCEL#: 29053100302300 crTY EVERETT STATE WA ZIP 98155 SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME: SERAH KIAMA OWNER MAILING ADDRESS: STREET 614 48TH STREET SE CITY EVERETT STATE WA ZIP 98203 OWNER PHONE: 425-4953612 OWNER EMAIL: bongnl@hotmail.com CONTRACTOR COMPANY NAME: TBD Cr-WI/kW WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) DESIGNER CONTACT NAME: CONTACT PHONE: 206-6832395 CARMELO N LAVISTE CONTACT EMAIL: cnIdesign.drafting@gmail.com PLUMBING PERMIT INFORMATION VALUATION OF WORK: $ 8000.00 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: ❑✓SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure DESCRIPTION OF WORK: Install new walk-in shower and bathtub and relocate all existing fixtures per plan PLUMBING PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (QtY) (Qty) Backflow Prevention Device(Inside Building)-select devices below: 2 Shower,Tub,or Combo Fire Service:❑DCDA, Domestic Service:❑RPBA❑DCVA Commercial Sink(3-compartment,prep,floor) Clothes Washer Residential Sink(kitchen,bath,bar) Dishwasher 3 Utility Sink(laundry,mop) Drinking Fountain 2 Toilet Floor Drain Urinal Hose Bibb Waste/Water Pipe Repair Ice Maker Water Service Line(Behind meter,private side) Grease Interceptor Water Valves/Fixtures Sand/Oil Interceptor 1 Water Heater-Electric Medical Gas Water Heater-Gas Roof Drains Other(List Type): Sewage Ejector Pump/Sump Pump Other(List Type): 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 PERMIT# to Lz-- P ZZo 1 — ® 1 Owner/Authorized Agent Si ure Date (Revised 2/8/2021)