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PERMIT APPLICATION <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 1 FAX 425-257-8857 1 (E) everetteps@evereltwa.gov I www,everettwa.gov/permits <br />Blue or Bleak Ink Only PleesePROJECT SITE INFORMATION <br />ROJECT SITE ADDRESS: 3322 52nd PI. S.W. <br />PROPERTY TAX #: 00396700203200 <br />EGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />ER NAME: Bradley & Kim Larssen <br />OWNER MAILING ADDRESS: ST11IT3322 52nd PI. S.W. <br />cnY Everett <br />ER PHONE: 206-963-2815 <br />TENANT BUSINESS NAME (Comm <br />STATE WA <br />OWNER EMAIL: kimboonelarssen@gmail.com <br />CONTRACTOR NAME: Done Right Construction & Restoration, LLC <br />ZIP 98203 <br />CONTRACTOR ADDRESS: STREET P.O. BOX 851 98275 <br />CITY MUKILTEO STATE WA ZIP <br />CONTRACTOR PHONE. 425-344-9668 CONTRACTOR EMAIL: aarong@donerightconstruct.com <br />NTRACTOR LICENSE #(REQUIRED) DONERRC933PZ (CITY OF EVERETT BUSINESS LICENSE <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR I]' OTHER (Please Specify) Owners Agent <br />CONTACT NAME: CONTACT PHONE:206-281-7500 <br />Chris Bacus - Pacific Engineering Tech. CONTACT EMAIL: cbacus@pacer <br />BUILDING INFORMATION <br />com <br />Existing Use of Building: Single Family Residence lContract Price of Work: $ <br />Proposed Use of Building: Heat Source: []Gas ❑Electric ❑Other <br />BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family- # Units: ❑Commercial ❑Accesso Structure <br />Type of Pro'ect: ❑New ❑Addition ❑Remodel ©Re air ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Chan a of Use <br />DESCRIPTION OF WORK: Fire Damage Walkthrough. We will also be asking if a Demo Permit will be required to remove some <br />finishes in the Bathroom and Kitchen to survey any additional structural damage to the Residence. <br />>SSOCIATED BUILDING PERMIT # if applicable): <br />PLUMBING PERMIT APPLICATION <br />MECHANICAL PERMIT APPLICATION <br />Fixture Fixture <br />List of Fixtures List of Fixtures <br />Fixture <br />Fixture List of Fixtures List of Fixtures <br />Count Count <br />Count Count <br />In <br />Piping <br />Gas Pi <br />Backflow Preventer Inside Bldg) Shower, Tub, or Combo <br />A/C — Air Handling Units <br />Sink -Commercial (3-comre ,floor) <br />Clothes Washer p,p <br />Boiler Gas Range <br />Dishwasher Sink -Residential (kilchen,bath,bar) <br />Clothes Dryer Heat Pump&Ductless <br />Drinking Fountain Sink -Utility, laundry, mop <br />Duct System (Remodel) Refrigeration <br />Toilet <br />Exhaust Fans (Residential) Commercial Ventilatior <br />Floor Drain Urinal <br />Exhaust Hood (Type I) (Not Heat/AC system) <br />Hose Bibb <br />Interceptor -Grease WastefWater Piping Repair <br />Exhaust Hood (Type ll) Water Heater <br />Interceptor-Sand/Oil Water Service (behind meter) <br />Exhaust Hood (Residential) Wood Stove <br />Medical Gas Water Valves or Fixtures <br />Forced Air Systems Other: <br />Roof Drains Water Heater <br />Gas Fireplace/Insert/Log <br />SPRINKLER / SUPPRESSION SYSTEM <br />Sewage Ejector or Sump Pump Other: <br />Water Suppression System No. of Heads <br />Chemical Suppression System No. of Heads <br />information contained herein is true and correct. Work done pursuant to this permit must comply with <br />ACKNOWLEDGEMENT: 1 have reviewed this application and confirm the <br />approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />current federal, state, and local law. The granting of a permit only authorizes <br />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 />Building Official <br />and ! comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT # h <br />, +�D <br />CIA, - <br />April 15, 2019 <br />Date (Revised 10/10/2018) <br />Owned %uthorized Agent Signature <br />