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41:677- PERMIT APPLICATION 1111 <br /> BUILDING I MECHANICAL/PLUMBING I SIGN I SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 08201 <br /> (I')425-257-8810 I FAX 425-257-8857 j(E)everetteps@everettwa,gov I www.everettwa.govlpermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 9113 9TH AVE SE PROPERTY TAX#: -00663700001200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: I3EKELE YITAGESSU SAHILE SENITE TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 9113 9TT H AVE SE <br /> CrrY , EVERETT STATE WA zip 98208-:3316 <br /> OWNER PHONE: 4252453952 OWNER EMAIL: yitabeltele@gmail.com <br /> CONTRACTOR NAME: TBD C...a.r[as Oak, c rej c_e-5 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: nt CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): C_A _L o 1 9 9/ Q E CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6(q?S <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR 'OTHER(Please Specify)—drafter <br /> CONTACT NAME: CONTACT PHONE: 206240 7006 <br /> Joey Perez CONTACT EMAIL: draftnvf@gmajl.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ 120,000.00 <br /> Proposed Use of Building: _ _ __ __ , , _ Heat Source: I IGas ClElectric Daher <br /> Building Type: OSFR-Detached IJSFR Attached DDupiex DMultl-Family-#of Units: IJCommerciat Dlndustrial <br /> Type of Project: ❑New ClAddition I!3'Remodel ❑Repair OT.I. COSign CDSprinkler ODemolltion OChange of Use <br /> DESCRIPTION OF WORK: <br /> Convert garage to 4 bedrooms and bath. Convert family room to 2 bedrooms&add a ramp. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration ^Repair Type of Project: New 4ddn `Alteration ,Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C--Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains _ <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> _ SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I 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 /> end 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 1/7/2022 PERM-IT 62' <br /> 20 <br /> Owner/Authorized Agent Signature Date (Revised 99/23/2016) <br />