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0 PERMIT APPLICATION* <br />EVERETT <br />wASH!NGTON <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />Blue or Blade Ink Ont Plomo PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:1033 TEMPLE DR <br />PROPERTY TAX #: 005962-004-003-02 <br />LEGAL for new construction: Short Plat/subdivision- Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: JONATHAN REMPEL TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET 1033 TEMPLE DR <br />c,n EVERETT STATE WA zip 98201 <br />OWNER PHONE: 657-272-6121 <br />OWNER EMAIL: REMPEL808@GMAIL.COM <br />CONTRACTOR NAME: JONATHAN REMPEL - HOME OWNER <br />CONTRACTOR ADDRESS: STREET 1033 TEMPLE DR <br />CITY EVERETT STATE WA Zip 98201 <br />CONTRACTOR PHONE: 657-272-6121 <br />CONTRACTOR EMAIL: rempel808@gmail.com <br />CONTRACTOR LICENSE #(REQUIRED): JDREMRC815RS <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): Home owner <br />PRIMARY CONTACT: 0 OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />JONATHAN REMPEL <br />CONTACT PHONE:657-272-6121 <br />CONTACT EMAIL: REMPEL808@GMAIL.COM <br />BUILDING INFORMATION <br />Existing Use of Building: SFR <br />Contract Price of Work: $175,000 <br />Proposed Use of Building: SFR <br />Heat Source: OGas ElElectric ❑Other <br />BUILDING USE: EISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑✓ Addition ORemodel ❑Repair ❑T.I. ❑Sin ❑Sprinkler ❑Demolition ❑Chan a of Use <br />DESCRIPTION OF WORK: General use updates. Add 2 bathrooms, finish basement, rough in MIL kitchen, update electrical down <br />and upstairs to meet current code, new electrical panel and basement sub -panel, plumbing repairs and upgrades, reinforce <br />roof, sound dampening in daylight basement walls and ceilings, new insulation throughout, addition to south end of home. <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 Fix <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C —Air Handling Units <br />Gas Pipi <br />Backflow Preventer (inside Bldg) <br />4 <br />Showe or Combo <br />Boiler <br />2 <br />G aV 06nge <br />Clothes Washer <br />ommercial (3-comp, prep, floor) <br />ink -Residential (kitchen, bath, bar) <br />s Dryer <br />4 <br />eat Purnp&Ductless <br />2 <br />ishwasher <br />6 <br />Duct S (Remodel) <br />Refrigeration <br />Dr Fountain <br />Sink -Utility, laund.y, mop <br />4 <br />Exhaust Fans identi <br />Commercial Ventilatio <br />(Not Heat/AC system) <br />Floor Dra <br />4 <br />Toilet <br />Exhaust Hood (Typ <br />Hose Bibb <br />Urinal <br />Exhaust Hood e II) <br />_Jje2 <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust (Residential) <br />&ood Stove <br />Interceptor -San <br />Water Service (behind meter) <br />Fore it Systems <br />O <br />Medical Ga <br />Water Valves or Fixtures <br />1 <br />Fireplace/insert/Log <br />Roof D s <br />2 <br />Heater <br />041tRINKL.ER <br />/ SUPPRESSION <br />SYSTEM <br />s ge Ejector or Sump Pump <br />Other: <br />Wa r Suppression System <br />No. of Heads <br />Chemical Suppression System <br />No. of Heads <br />ACKNOWLEDGEMENT. / 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. / am the owner, or / am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />V14*-4 <br />horized Agent Signature <br />Date <br />City of Everett Official Use Only <br />PERMI #),-') <br />(Revised 10110,12018) <br />Yz-. <br />