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1' II II''II PERMIT APPLICATION <br /> "� BUILDINMECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> I11111►' CITY OF EVERETT PERMIT SERVICES <br /> .y. 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 /> . ." ¢.,. .. ,4...=6' t lhry 0;, ,.,.: % ,. .:; s-a:- :mr ,.. .:.,T1 :? .;a,•T ,.,,,g a»-' '. .;54. <br /> PROJECT SITE ADDRESS: 2103 Virginia Avenue,Everett WA 98201 PROPERTY TAX#: 00401544300102 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NAME: Avianca Walker TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3923 107th PI NE <br /> crr' Marysville STATE WA ZIP 98271 <br /> OWNER PHONE: 206.701.4022 OWNER EMAIL: aviancaj@gmail.com <br /> CONTRACTOR NAME: Curtiss Construction Co. <br /> CONTRACTOR ADDRESS: STREET 8303 143rd Ave NE <br /> crw Lake Stevens STATE WA ZIP 98201 <br /> CONTRACTOR PHONE: 425.239.2941 CONTRACTOR EMAIL: Curtiss@curtissconstructionco.com <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR III OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: 206.931.0990 <br /> Garin Schenk-Architecture Studio of Everett CONTACT EMAIL: garin@archstudioeverett.com <br /> Existing Use of Building: single-family residence Contract Price of Work:$ $120,000.00 <br /> Proposed Use of Building:single-family residence Heat Source: IIIGas ❑Electric ❑Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial CI Industrial <br /> Type of Project: New ❑Addition ❑Remodel El Repair ❑T.I. El Sign ❑Sprinkler ❑Demolition El Change of Use <br /> DESCRIPTION OF WORK: <br /> Construction of previously demolished single-family residence,replaced in-kind to the standards of the Riverside Historic Preservation Committee. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): C-1705-002 <br /> Type of Project: New _ Addn _Alteration _Repair Type of Project: X New _Adds _Alteration _Repair <br /> #of #of List of Fixtures List of Fixtures #°f List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handlin• Units —Heat Pump 2 Toilet _Backflow Preventer(Inside Bide) <br /> Forced Air S stems —Unit Heater 1 Bathtub —Urinal <br /> new Gas Piein• 1 Boiler 3 Lavato Wash Basin) —Drinkin• Fountain <br /> 1 Water Heater —Refri•eration 1 Shower —Floor Drain <br /> 1 Gas Fireelace —Wood Stove 1 Kitchen Sink&Disposal Grease Trap <br /> 1 Gas Ranee —Ductine 1 Dishwasher —Roof Drains <br /> 1 Clothes D er Hooku es —Other: 1 Clothes Washer —Medical Gas <br /> 1 Ranee Hood 1 Water Heater —Other: <br /> 3 Exhaust Fan —Sink Service/Bar/Moe/etc. —Other: <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/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 /> C\ <br /> 10.20.2017 LPERMIT#C <br /> City of Everett Official Use Only <br /> /� <br /> J o CL <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) rem l w1 <br />