9507 18TH AVE W 2019-06-05 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT.WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 9507 18th Ave . W. PROPERTY TAX#: 00947000000200 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Paul Nguyen TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 9507 18th Ave . W. cn-y Everett STATE WA ZIP 98204 OWNER PHONE: 425-404-0200 OWNER EMAIL: Yvanpa12002@yahoo . com CONTRACTOR NAME: Eric Gagon - Kustom US CONTRACTOR ADDRESS: STREET 7733 W. Bostian Rd. , Suite 1-B cTv Woodinville STATE WA ZIP 98072 CONTRACTOR PHONE: 425-892-1901 CONTRACTOR EMAIL: e r i c .gagon@kustom.us CONTRACTOR LICENSE#(REQUIRED): KUSTOUI 84 7NQ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 056203 PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ®OTHER (Please Specify) Agent CONTACT NAME: CONTACT PHONE: 206-281-7500 Chris Bacus-Pacific Engineering Tech. CONTACT EMAIL: cbacus@pacengtech.. com BUILDING PERMIT APPLICATION Existing Use of Building: Single Family Residence Contract Price of Work: $ 5 0 , 0 0 0 Proposed Use of Building: Heat Source: ®Gas ❑Electric ❑Other Building Type: ESFR-Detached ®SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ®Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: (See Attached) t--((ye.- Da c 1 P r, ASSOCIATED BUILDING PERMIT#(if applicable): D I Ge,‘,14., ‘P15 f 0./tedi MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration Repair Type of Project: New Addn Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) _Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water ( No.of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT it 4/25/17 t-1 04-* 61 ---1---1 Owner/Authorized Agent Signature Date (Revised 9/23/2016) �L