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Mira BUILDINLIECHANICAL/ PLUMBING/SIGN JiJpRINKLER/ DEMOLITION <br /> EVERETTCITY OF EVERETT PERMIT SERVICL3 <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blum or Black Ink Only Rom) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: E. Beech St, Everett, WA. PROPERTY TAX#: 00371400004000 <br /> LEGAL for new construction: Short Plat/subdivision Airport Acres Lot No.40 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Harold/Connie Wilson TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 133 E. Beech St. <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE: 425.422.1633 OWNER EMAIL:hainconnie@frontier.conl <br /> CONTRACTOR NAME:RAM JACK WEST <br /> CONTRACTOR ADDRESS: STREET 862 Bethel Drive <br /> Eugene Oregon 97402 <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE:541-688-7177 CONTRACTOR EMAIL:info@ramjackwest.corn <br /> CONTRACTOR LICENSE#(REQUIRED):RAMJAW*852P CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57547 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) Korey Yada-Agent/Contractor <br /> CONTACT NAME: CONTACT PHONE:541-852-1976 <br /> Korey Yada CONTACT EMAIL:Korey@ramjackwest.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:SI-H Contract Price of Work:$19,876.00 <br /> Proposed Use of Building:No change to footprint Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU DMulti-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Sign ❑Sprinkler DDemolition DChange of Use <br /> DESCRIPTION OF WORK: Voluntary foundation repairs to stabilize portion of existing foundation. No change to footprint. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FixtureFixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer - Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) _ (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log 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 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.lam the owner,or lam 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 /> 7,771.0(fPERM <br />