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PERMIT APPLICATION* <br />BUILDING / MECHANICAL / PLUMBING I SIGN I SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 10 everette -R—e—w- <br />r, vov I —everenwa.goViperMILS, <br />�(Blu* or Black Ink On Plots") PROJECT SITE INFORMATION <br />— <br />PROJECT SITE ADDRESS: 10829 19th AVE SE., EVERETT, WA 98207 <br />1 <br />PROPERTY TAX #; <br />LEGAL for new construction: Short Plat/subdivision A"6MZ, Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: ALTHEA SCHLUMPF TBUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREE710829 19TH AVE SET4A ) <br />crry EVERETT sTATEWA vp 98208 <br />OWNER PHONE:425-345-9745 -[OWNER <br />EMAJL:althea@altheas.net <br />CONTRACTOR NAME:DONE RIGHT CONSTRUCTION and RESTORATION, LLC <br />CONTRACTOR ADDRESS; STREETPOBOX 851 <br />c,, MUKILTEO STATE WA zip 98275 <br />--CONTRACTOR <br />CONTRACTOR PHONE:425-344-9668 - <br />EmAiL.aarong@donerightconstruct.com <br />CONTRACTOR LICENSE #(REQUIRED): don errc933 pz <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 55842 <br />PRIMARY CONTACT: 171 OWNER 0 CONTRACTOR 1:1 OTHER (Please Specify) <br />CONTACT NAME: <br />LAaron Glenn <br />CONTACT <br />CONTACT PHONE: 425-344-9668 <br />EMAJL:aarong@donedghtconstruct.com <br />BUILDING INFORMATION <br />Existing Use of Building: <br />Contract Price of Work: $ 10 00 50 <br />Proposed Use of Building: <br />Heat Source: OGas -f3Electric ©Other <br />BUILDING USE: QSFR OTownhouse ElDuplex OADU EDMulb-Farnily - # Units: - [3cornmercial ElAccessoa-Structure <br />1Xpe of Project: ONew DAddition ORemodel E'Repair C3T,I. _ OSign CJSprinkler ODernolidon ElChange of Use <br />DESCRIPTION OF WORK: Install ()(4 new trusses, remove/replace insulation, drywall, peftftiflg-, roofing replacement <br />3 <br />LASSOCIATED BUILDING PERMIT # if a22ficable): <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 />x <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 />I Backflcw Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boller <br />Clothes Dryer <br />Duct System (Remodel) <br />Exhaust Fans (Residential) <br />Gas Range <br />Heat Pump&Ductless <br />Refrigeration <br />Commercial Vantilatior <br />(Not_Heat/AC system) <br />Clothes Washer <br />Dishwasher <br />I Drinking Fountain <br />Floor Drain <br />_ <br />Sink -Commercial (3-comp,prep,floor) <br />Sink -Residential (kitchen, bath, bar) <br />Sink -Utility, laundry, mop <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Exhaust Hood (Residential) <br />Forced Air Systems <br />Gas Fireplace/InsertlLog. <br />Water Heater <br />Wcod Stove <br />Other: <br />Interceptor -Grease <br />Interceptor-Sand/Oil <br />Medical Gas <br />Roof Drains <br />Waste/Water Piping Repair <br />Water Service (behind motor) <br />Water Valves or Fixtures <br />Water Heater <br />SPRINKLER I SUPPRESSION <br />Water Suppression system <br />[Chemical Suppression System I <br />INo. <br />SYSTEM <br />Ne. of Heads <br />of Heads <br />Sewage Ejector or Sump Pump <br />Other <br />I , 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 wnfing 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 />411M <br />Signature <br />City of Evereff Official Use Only <br />PERMIT # B2104-036 <br />(Revised 1011012018) <br />1/� <br />