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PERMIT APPLICATION <br /> 1112 <br /> BUILDING/ MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black InkOnlyNilee=s) PROJECT SfITE,'INIORMATION K4:xaF.,+ <br /> t 4 <br /> PROJECT SITE ADDRESS:101 1 W Mukilteo Blvd Everett, WA 98203 PROPERTY TAX#:00505800000902 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Craig Chapman TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 1011 W Mukilteo Blvd <br /> cm, Everett STATE WA ZIP 98203 <br /> OWNER PHONE:425-220-1792 OWNER EMAIL:CChapman530@hotmail.COm <br /> CONTRACTOR NAME:R&R Foundation Specialist LLC <br /> CONTRACTOR ADDRESS: STREET3409 McDougall Ave Suite 204 <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-760-5077 CONTRACTOR EMAIL:info@rrspecialist.net <br /> CONTRACTOR LICENSE#(REQUIRED):RRFOU FS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Project Coordinator for R&R <br /> CONTACT NAME: CONTACT PHONE:425_248_8813 <br /> Lauren Chapman CONTACT EMAIL:lauren@rrspecialist.net <br /> ;..:' BUILDING,INFORMATION �.,,.... <br /> Existing Use of Building:SFR Contract Price of Work:$ "—D I Ufel D <br /> 91 <br /> Proposed Use of Building:SFR Heat Source: OGas ❑Electric ❑Other <br /> BUILDING USE: OSFR ETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ✓❑Repair ❑T.I. ❑Sign LISprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install (9)3"concentric piles along the Eastern corner and Southeastern wall of the foundation <br /> of the residence to lift structure back to practical maximum recovery. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> '„ ,.,.. ;MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION ,,,dir <br /> FixtureFxture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—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 Ventilatior 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 °;SI PPRESSION SY...STEM..;', 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.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 /> fir _ 4Z / ( PERMIT 4-0 tct 62G <br /> . ner/Authorized Agent Signature Date (Revised 10/10/2018) <br />