3205 LOMBARD AVE 2022-02-18 - Laserfiche WebLink

PERMIT APPLICATIO BUILDIN&ECHANICAL / PLUMBING / SIGNWPRINKLER / DEMOLITION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 i FAX 425-257-8857 i (E) everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:3205 Lombard Ave, Everett, WA 98201 PROPERTY TAX #: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Temple Beth Or TENANT BUSINESS NAME (Commercial): OWNER MAILING ADDRESS: 111EET3215 Lombard Ave crry Everett STATE WA z,P 98201 OWNER PHONE: (425) 259-7125 OWNER EMAIL:offlce@templebethor.com CONTRACTOR NAME: Bobby Wolford Trucking & Demolition CONTRACTOR ADDRESS: STREET22014 W. Bostian Road CITY Woodinville STATE WA ZIP 98072 CONTRACTOR PHONE:206-715-6021 1CONTRACTOR EMAIL:estimating@wolfordtrucking.com CONTRACTOR LICENSE #(REQUIRED): BOBBYWT088CC ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 60355 PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR El OTHER (Please Specify) representitive of Temple Beth Or CONTACT NAME: Koby Wexler CONTACT PHONE: 425-31 5-5525 CONTACT EMAIL:Koby@wexlerpropertygroup.COm BUILDING INFORMATION Existing Use of Building: Duplex- residential Contract Price of Work: $25,180 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑✓ Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ✓❑Demolition ❑Change of Use DESCRIPTION OF WORK: Remove Asbestos in fire damaged building, Demolish uplex. Asbestos work subbed by bobby wolford to ACKS DEMO & CONSTRUCTION�CL# ACKSDDC851 DP ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Count List of Fixtures Fixture Count List of Fixtures Fixture Count List of Fixtures Fixture Count List of Fixtures A/C — 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 (Not Heat/AC system) Floor Drain Toilet Exhaust Hood (Type 1) 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 I 10ther Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains lWater Heater SPRINKLER / SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System I lNo. of Heads Chemical Suppression System I lNo. of Heads ACKNOWLEDGEMENT: / 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. 1 am the owner, or l am authorized by the owner of this property to perform the work for which application is made, and / comply with the State Contractors Law 18.27 RCW and 296.200A WAC. zed Agent Signature City of Everett Official Use Only PTMT # Co 2G / l0�` - ate (Revised 1011012018) `)