Laserfiche WebLink
OLT PERMIT APPLICATION <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 I FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:110 82ND PL SW PROPERTY TAX#:00393500002407 <br /> LEGAL for new construction: Short PlaUsubdivision BEVERLY HOMESITES Lot No.4 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:ROWENA ALIX TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 110 82ND PL SW <br /> c,n EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE:425-2204825 OWNER EMAIL:ROWENAALIX©FRONTIER.COM <br /> CONTRACTOR NAME HOME DEPOT USA INC <br /> CONTRACTOR ADDRESS: STREET2455 PACES FERRY RD <br /> CITY ATLANTA STATE GA ZIP 30339 <br /> CONTRACTOR PHONE:800-381-5699 CONTRACTOR EMAIL:HD@NWPERMIT.COM <br /> CONTRACTOR LICENSE#(REQUIRED):HOMED**088RH CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)�"� <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR @ OTHER(Please Specify) CONTRACTOR'S AGENT <br /> CONTACT NAME: CONTACT PHONE:360-945-2787 <br /> CHLOE BARKER/ NW PERMIT INC CONTACT EMAIL:HD@NWPERMIT.COM <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:SFR Contract Price of Work: $10,941.28 <br /> Proposed Use of Building:SFR Heat Source: ❑Gas ❑Electric DOther <br /> Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of ProojLse�ct. :New DAddition DRemodel Repair DT.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use <br /> RZ� 1rrAFg ZTjRIesW9 i 5p and 5 squares/sheets of decking; 1/2"CDX,6/12 nail pattern,4'staggered,24"OC.(No plywood unless found at time of install.) <br /> Owens-Corning-Oakridge-Color:Onyx Black <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Chemical or Water No. of Heads <br /> 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 <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.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 /> City of Everett Official Use Only <br /> Chloe Barker Datfh <br /> e 2018.04.25 <br /> 1ly signed y10:22:50 Chloe Barker PERMIT-0700' 04/25/2018 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) l• <br />