1702 WETMORE AVE 2024-10-25 - Laserfiche WebLink

PLUMBING PERMIT APPLICATION EVERETT SUBMITTAL INSTRUCTIONS: OF EVERETT PERMIT SERVICES S: Drop off hard copy completed paper application to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION: (P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET (� W e (e PARCEL M L 3D3 10 3 I U) CITY Lv STATE (� ZIP (� SUITE/UNIT M FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME: y) 1�OU j OWNER MAILING ADDRESS: STREET totIo CITY 62 STATE ZIP z OWNER PHONE: qZ_rWOZ OWNER EMAIL: CONTRACTOR COMPANY NAME: Epi ' `�1I1��j;V1. / EDL. r� L. 0 WA STATE CONTRACTOR LICENSE#(REQ++UIRE • E'D L P I- ID Ll'#D CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET I �e? 6 15*' {T VL CITY ��V ( STATE ZIP CONTRACTOR PHONE: S 2113 q 7,32 1CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER (,CONTRACTOR ❑ OTHER(Please Specify) C CONTACT NAME: CONTACT PHONE: q2,5 SY3 r 3Z CONTACT EMAIL: 4, PLUMBING PERMIT INFORMATION VALUATION OF WORK:$ 7 OCA, ASSOCIATED PERMIT#(if applicable): 1361 ~ L)4,1 (Valuation shall Include the prevalling fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: EKFR ❑Townhouse ❑Duplex ❑ADU []Multi-Family-#Units: ❑Commercial ❑Accessory Structure DESCRIPTION OF WORK: Re �� Ki t�►�e�� t � cit, , 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: 14 Shower,Tub,or Combo Fire Service:❑DCDA, Domestic Service: ❑RPBA❑DCVA Commercial Sink(3-compartment,prep,floor) ( Clothes Washer 3 Residential Sink(kitchen,bath,bar) Dishwasher Utility Sink(laundry,mop) Drinking Fountain I Toilet Floor Drain Urinal ;j Hose Bibb Waste/Water Pipe Repair Ice Maker Water Service Line(Behind meter,private side) Grease Interceptor Water Valves/Fixtures Sand/Oil Interceptor Water Heater-Electric Medical Gas Water Heater-Gas Roof Drains Other(List Type): Sewage Ejector Pump/Sump Pump Other(List Type): ACKNOWLEDGEMENT.,1 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 Oficial before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Qu- Z ZY PERMIT# 'a�0( vol 4 Owner/Authorized A I It SidKature Date (Revised 4/21/2022)