2612 E GRAND AVE 2021-11-12 - Laserfiche WebLink

• PERMIT APPLICATION BUILDING/MEFH NIC-AL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 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:2612 E Grand Ave Everett WA 98201 PROPERTY TAX#:00516859202000 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Shaylee Blubaugh TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET2612 E Grand Ave CITY Everett STATE WA ZIP 98201 OWNER PHONE: 425-971-7524 OWNER EMAIL:shayleerb@gmail.com CONTRACTOR NAME:R&R Foundation Specialist CONTRACTOR ADDRESS: STREET 3409 McDougall Ave Suite 204 CITY Everett STATE WA zip 98201 CONTRACTOR PHONE:425-626-4841 CONTRACTOR EMAIL:barbara@rrspecialist.net CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 PRIMARY CONTACT: ❑OWNER CI CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-626-4841 Barbara Stasiak CONTACT EMAIL:barbara@rrspecialist.net BUILDING INFORMATION Existing Use of Building:SFR Contract Price of Work:$13497.50 Proposed Use of Building:SFR Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: IDSFR ❑Townhouse ElDuplex ❑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: crew will install posts on existing footings to lift home to maximum practical recovery and pour new porch ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count of Fixtures Count List of Fixtures 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 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/Insert/Log 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:/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.lam the owner,or I 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. City of Everett Official Use Only ga26a4.42 c5" 24uoA 12/1/2020 2 �`2 Owner/Authorized Agent Signature Date (Revised 10/10/2018) //Zi