1011 TEMPLE DR 2022-01-13 - Laserfiche WebLink

• PERMIT APPLICATIOA BUILDING/ MECHANICAL/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 (BIMO or Black Ink Only Please): PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1011 Temple Drive PROPERTY TAX#:00596200400100 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Jeanne and Thomas Crisp TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1011 Temple Drive c„y Everett STATE WA zip 98201 OWNER PHONE: 425-737-0351 OWNER EMAIL:jeanne@crisp4.com CONTRACTOR NAME:R&R Foundation Specialist CONTRACTOR ADDRESS: STREET3409 McDougall Ave Suite 204 cin, Everett STATE W@rrsApecialist.net 98201 CONTRACTOR PHONE:425-626-4841 CONTRACTOR EMAIL:barbara@rrspecialist.net CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 PRIMARY CONTACT: 0 OWNER Ei 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:$11,910.00 Proposed Use of Building:SFR Heat Source: ❑Gas DElectric DOther BUILDING USE: IZ1SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New DAddition ❑Remodel ❑✓Repair ❑T.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: crew will install helical piles and stabilize and lift home to maximum practical recovery ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Future Fixture Fixture Count List of Fixtures CountList of Fixtures Count List of Fixtures Count List of Fixtures NC—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 Ventilation 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 f'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 being authorized under any circumstance.lam the owner,or/am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only ._ / PERMIT# �`�.z O� dt�.6a'.�&- 5Z.�ei;,�;L>4 1/25/2021 Owner/Authorized Agent Signature Date (Revised 10/10/2018) ��2