1406 MADRONA AVE 2020-05-08 - Laserfiche WebLink

PERMIT APPLICATIOr grrBUILDING I MECHANICAL/ PLUMBING I SIGN / SPRINKLER I`DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1406 MADRONA AVE PROPERTY TAX#:00505700002200 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: DENNIS & JILL RYAN TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET1406 MADRONA AVE airy EVERETT STATE WA z,F 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: LAKEVUE RENOVATIONS CONTRACTOR ADDRESS: STREET 6302 SYCAMORE PL crit EVERETT STATE WA ,,, 9820 CONTRACTOR PHONE:206-719-2060 CONTRACTOR EMAIL: JEFFCDODGE@LIVE.COM \ CONTRACTOR LICENSE#(REQUIRED):LAKEVR*891 RK CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) DESIGNER CONTACT NAME: CONTACT PHONE:425-478-0340 PAUL MONSON CONTACT EMAIL:BAJA-BUILD@MSN.COM //�� BUILDING INFORMATION ExistingUse of Building: Contract Price of Work:$ / Proposed Use of Building: .‹.f� Heat Source: ❑Gas Electric Dottier ,11P.:I F- BUILDING USE: 4715FR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial OAccess.,• ucture Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REPLACE EXISTING DECK&ADDD11 SQ FT NEW sgOO` t 'A Com ‘ 1(\ -l-�`i ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior^ Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/InserULog Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 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 Building Official before being authorized under any circumstance tam the owner,ort am authorized by the owner of this property to perform the work for which application is made, and I co • 'h the State Contractors Law 18.27 RCW and 296.200A WAC. I'( City of Everett Oficial Use Orly� PE # 3 1-25-2019 I CA O( /Q O dr Agent Signature Date (Revised 10/10/2018) 112