1030 HOYT AVE 2021-11-15 - Laserfiche WebLink

NMI PERMIT APPLICATION ik BUILDING ECHANICAL 1 PLUMBING/SIGN / INKLER/ DEMOLITION E V E R K 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 (Blueor Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1030 hoyt Ave Everett, WA 98201 PROPERTY TAX#:00468621503101 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Sharon Knudson TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET1030 Hoyt Ave C,-- Everett STATE WA ZIP 98201 OWNER PHONE:425-252-9129 OWNER EMAIL: CONTRACTOR NAME: Back Forty Construction, LLC CONTRACTOR ADDRESS: STREET 27419 118th St SE CITY Monroe STATE WA ZIP 98272 CONTRACTOR PHONE:360 793 2899 CONTRACTOR EMAIL: BaCk40C@msn.COr1't CONTRACTOR LICENSE#(REQUIRED): BACKFFC914P6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 56480 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425 232 3737 Mike Clothier CONTACT EMAIL:BaCk40C@MSn.COM BUILDING INFORMATION Existing Use of Building: SFR Contract Price of Work:$15,200 Proposed Use of Building: SFR Heat Source: DGas DElectric ❑Other BUILDING USE: DSFR ❑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: Build front and back porch covers ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixtur Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of ures NC—Air Handling Units Gas Piping Back Preventer(Inside Bldg) G Shower ,or Combo Boiler Gas Range y Clothes er Si - ommercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless /, Dishwasher Z, 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) I Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Gre Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Intercepto and/Oil Water Service(behind meter) Forced Air Systems Other: Me • Gas r Valves or Fixtures Gas Fireplace/Insert/Log oof Drains Water ter 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 eing 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, and I comply wit th tate Contractors Law 18. W and 296.200A WAC. City of Everett Official Use Only PERT#./z-c./ a _ CO(. Owner/Authorized Agent Signature Date (Revised 10/10/2018)