Laserfiche WebLink
41en- PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING I SIGN I SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 96201 <br /> (Pt 425-257-8610 1 FAX 425-257-6857 I(E)e,,- tepsiteverettwa.gov I wa w.everet ra g:.,<permr. <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:1004 110TH PL SE, EVERETT,WA 98208 PROPERTY TAX#: 007625000o-1000 <br /> LEGAL for new conslr,-t ' S'.ort Pla&sub ,,'on I ARS _i PARK DIV 1&2 ,,.t,- 1 r ..,,,..:,. ` 1.;.-.,,,,,,rt731 Aescxi7++,^? <br /> CONTACT INFORMATION <br /> OWNER NAME: MULATU YIRBA TENANT BUSINESS NAME(Commeralaly <br /> OWNER MAILING ADDRESS: sraeer 1004 110TH PL SE <br /> Gi-r. EVERETT STATE WA zu> 98208 <br /> OWNER PHONE: 206-697-9981 [OWNER EMAIL: MULATUSH(a?GMAIL.COM <br /> CONTRACTOR NAME: TBD <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: -1GONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): 1GITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Residential Designer <br /> CONTACT NAME: CONTACT PHONE: 206-6832395 <br /> CARMELO N LAVISTE CONTACTEMAIL: cnldesign.drafting@gmail,com <br /> BUILDING INFORMATION <br /> Existing Use of Building: <br /> Residential Contract Price of Work:$ 40000.00 _ _ <br /> Proposed Use of Building: Adult-Family Home Heat Source: ❑Gas OO Electric ❑Other ...__,,,.__. .. <br /> BUILDING USE: OSFR LiTO+YnhOrJSe ❑Duplex LJADU LiMulti-Family-#Units:_____,_ <br /> L1Commercial LlAccessory Structure <br /> Type of Project: ❑New ❑Addition ORemodel LiRepair DT.I. ❑Sign USprinkler LDD noldion UChange of Use <br /> DESCRIPTION OF WORK: Convert existing garage into 4 bedrooms,Interior alterations and converting existing lower floor <br /> Single-Family Residence into an Adult-Family Home <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION , <br /> Fixture Fixture List of Fixtures <br /> Frxarr° List of Fixtures m List of Fixtures List of Fixtures Count <br /> Count Countount Count <br /> , EtackOnw Preventer Onside Bldg) 1 Shower,Tub,or Combo <br /> NC-Air Handling Units Gas Piping r-- <br /> < Boiler Gas Range Clothes Washer $Sink- <br /> nk-CommercResi den tial al <br /> (kitche{3 con+p,prepn,bath,bar),tloo'1 <br /> 1 Clothes Dryer Float PumpBDuclless Dishwasher <br /> Refrigeration _ Drinking Fountain- Sink-Utility,laundry,mop <br /> Duct System(Remodel) Toilet <br /> 2 Exhaust Fans(Residential) Commercial Ventilatior Floor Drain <br /> T I) (Not Fleal/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Interceptor-Sand/0il Water Service(behind meter) <br /> Exhaust Hood(Residential) Wood Stove Water Valves or Fixtures <br /> Forced Air Systems Other _ Medical Gas <br /> Gas Fireplace/Insed/Log <br /> Roof Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed Ibis application and confirm the Information contained herein is Iron and correct.Work done pursuant to this permit must comply with <br /> current federal,stale,and local law.The granting of a permit only authorizes approved work and no deviations therefrom Deviations must first be auttronzed in writing from the <br /> Building Official before being auth•.rzed under any circumstance.I am lire owner,or!am aulhonzod by the owner of this property to perfomr the work for which application is made, <br /> and I comply ith the Slate Co' :rs La 8.27 RCW and 296.200A WAC City of Everett Official Uso Only <br /> PE PE T <br /> .•.., .. Sul <br /> ---04(?) <br /> � Date (Revisedl0/10.f?a18) <br /> Own: /Au orlzed � •n ••ignaturo <br />