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0 PERMIT APPLICATION I* <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />EVERETT 32CITY OF EVERETT PERMIT SERVICES <br />00 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/perrnits <br />(Blue or Black Ink Only Pleases PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 2610 Hillside Lane <br />PROPERTY TAX #: 00567900200,404 <br />LEGAL for new construction: Short Plat/subdivision. Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Alka Atal-Barrio TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET2610 Hillside Lane <br />c,TY Everett STATE WA zip 98203-1408 <br />OWNER PHONE: 425-327-2635 <br />OWNER EMAIL: abarrio@frontier.com <br />CONTRACTOR NAME: TBD <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR 0 OTHER (Please Specify) Russ Weiser. Designs Northwest Architects <br />CONTACT NAME: <br />Russ Weiser, Designs Northwest Architects <br />CONTACT PHONE: 360-629-344.1 <br />CONTACT EMAIL: Russ@designsnw.com <br />BUILDING INFORMATION <br />Existing Use of Building: Single Family Residential <br />Contract Price of Work: $ <br />Proposed Use of Building: Single Family Residential <br />Heat Source: []Gas ElElectric []Other <br />BUILDING USE: OSFR []Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial EJAccessory Structure <br />Type of Project: ❑New ©Addition ✓ORemodel ❑Re air LIT. 1. ❑Sin ❑S rinkler ❑Demolition ❑Chan e of Use <br />DESCRIPTION OF WORK: Additions to existing House including expanded Master Bedroom and Expanded Deck on Main level, <br />and Exercise Room Addition on Lower level. Interior remodel of Master Bedroom, Master Bathroom, Master Bathroom and <br />Laundry on Main Level, Relocation of Existing Stair and Remodel of Lower Level Bedroom, Closet and Bath. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />1 <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />1 <br />Clothes Washer <br />Sink -Commercial (3-comp, prep, floor) <br />1 <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />1 <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />1 <br />Sink -Utility, laundry, mop <br />6 <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />2 <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas'Water <br />Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />Roof Drains ; <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />INo. of Heads <br />Chemical Suppression System <br />I <br />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 />,/� �� ffPE r, <br />;gg��.L f6�o��'�` Z1 /` / �l Z .< <br />Owner/Authorized Agent Signature Date (Revise(x 1011012018) <br />