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PERMIT APPLICATIC:: <br /> IIla <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 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:5OO5 Fowler Ave PROPERTY TAX#:00394600003000 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Tim O'Dell TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREET5OO5 Fowler Ave <br /> c,Tv Everett STATE WA ZIP 98203 <br /> OWNER PHONE: (425) 870-9215 OWNER EMAIL:tb.Odell U@COMCaSt.rlet <br /> CONTRACTOR NAME:R&R Foundation Specialist LLC <br /> CONTRACTOR ADDRESS: STREET3409 McDougall Ave ste 204 <br /> c,,, Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:(425)760-55077 CONTRACTOR EMAIL:Info@rrspecialist.net <br /> CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR El OTHER(Please Specify) Project Coordinator <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:$18,997.00 <br /> Proposed Use of Building:SFR Heat Source: ❑Gas 121Electric ❑Other <br /> BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New EAddition ❑Remodel I(Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install (7)3" helical piles along the Northern Perimeter and (3) 3" helical piles along the <br /> Eastern perimeter of the foundation of the residence to lift structure back to practical maximum recovery. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture <br /> List of Fixtures Fixture <br /> Count 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 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.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 /> i <br /> City of Everett Official Use Only <br /> ir A • PERMIT# <br /> �, 08/23/2019 1 <br /> — <br /> Owne Muthd Agen gnature Date (Revised 10/10/2018) <br />