5316 S 4TH AVE 2022-01-21 - Laserfiche WebLink

PERMIT APPLICATI• 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:5316 S. 4th Ave Everett, WA 98203 PROPERTY TAX#:00500600006500 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION: OWNER NAME: Jennifer Leese TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 5316 S. 4th Ave ow Everett STATE WA zip 98203 OWNER PHONE:425 622 4118 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.com CONTRACTOR LICENSE#(REQUIRED): BACKFFC914P6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 56480 PRIMARY CONTACT: 0 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:$ 8000.00 Proposed Use of Building: SFR Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ECommercial ❑Accessory Structure Type of Project: ❑New ❑Addition EJRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ['Demolition ❑Change of Use DESCRIPTION OF WORK: Re-Roof, Finish Drywall and Fire tape garage, Remove and re-build front steps ASSOCIATED BUILDING PERMIT#(if applicable): ,MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Court List 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: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 an 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 with the St Contractors Law 18. CW and 296.200A WAC. City of Everett Official Use Only I l / PE IT Owner/Authorized Agent Signature Date (Revised 10/10/2018)