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NMI • PERMIT APPLICATIO• <br /> BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> EVERETT CITY 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:321 Morgan Rd Everett WA 98203 PROPERTY TAX#:00393300008100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Walter Calder TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 321 Morgan Rd <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE: 425-353-5247 OWNER EMAIL:netuser@frontier.com <br /> CONTRACTOR NAME:R&R Foundation Specialist LLC <br /> CONTRACTOR ADDRESS: STREET3409 McDougall Ave Suite 204 <br /> cin Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-626-4841 CONTRACTOR EMAIL:barbara@rrspecialistnet <br /> CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 <br /> PRIMARY CONTACT: ❑OWNER CI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-626-4841 <br /> Barbara Stasiak CONTACT EMAIL:barbara@rrspecialist.net <br /> BUILDING INFORMATION <br /> Existing Use of Building:SFR Contract Price of Work:$19,974.00 <br /> Proposed Use of Building:SFR Heat Source: OGas DElectric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex EADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: crew will install helical piles and adjustable 4X4 post bases with pad to stabilize and lift foundation to <br /> (maximum practical recovery <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <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 Ventilatior 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 I 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296,200A WAC. <br /> City of Everett Official Use Only <br /> PERNILI# <br /> � /�l /�Q/Ll3Q/LCfi v5-&a 7f�/ 12/28/2020 621 ( J L— <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />