Laserfiche WebLink
47-T PERMIT APPLICATIO• <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 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION, . , <br /> PROJECT SITE ADDRESS:412 106th PL SE, Everett WA 98208 PROPERTY TAX#:00742900000800 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Sean Skelton TENANT BUSINESS NAME(Commercial): n/a <br /> OWNER MAILING ADDRESS: STREET412 106th PL SE <br /> cmi Everett STATE WA ZIP 98208 <br /> OWNER PHONE: 425-773-6043 OWNER EMAIL:paxquitil@hotmail.com <br /> CONTRACTOR NAME:Matvey Foundation Repair <br /> CONTRACTOR ADDRESS: STREET 1912 S 146th St <br /> CITY Seatac ' STATE WA Zip 98168 <br /> CONTRACTOR PHONE:253-327-1650 CONTRACTOR EMAIL:permits@gomatvey.com ` <br /> CONTRACTOR LICENSE#(REQUIRED):Matvefr837k5 CITY OF EVERETT BUSINESS LICENSE#(REQUI ED) Upl <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) Matvey Foundation Repair <br /> CONTACT NAME: CONTACT PHONE:253-680-9200 <br /> Tara Todd -Matvey Foundation Repair CONTACT EMAIL:permits@•. y ,e . om <br /> BUILDING INFORMATION <br /> Existing Use of Building:Single Family Residence Contract Price of ork:$8,350 <br /> Proposed Use of Building:Single Family Residence-no change Heat Source: Ni Gas DElectric DOther n/a <br /> BUILDING USE: EISFR ❑Townhouse ❑Duplex EADU ❑Multi-Family-#Units: ❑Com' ercial ❑Accessory Structure <br /> Type of Project: LiNew ❑Addition ❑Remodel ❑✓Repair ❑T.l. ❑Sign ❑Spr -. er ■Pt-molition ❑Change of Use <br /> DESCRIPTION OF WORK: Underpinning of the existing single family residence to stabilize the foundation. No alterations or <br /> additions to the existing footprint. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): n/a <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture 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 I 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.I am the owner,or/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 /> � ii�,j O� City of Everett Official Use Only - <br /> i�l �1 I l I PER O� — coS —. <br /> //ized (01Owned Agent Signature Date (Revised 10/10/2018) <br /> , (7: ) 2\A _ <br />