3018 21ST ST 2022-01-21 - Laserfiche WebLink

i• • PERMIT APPLICATIOte BUILDING/ MECHANICAL/ PLUMBING /SIGN /SPRINKLER/DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 l FAX 425-257-8857 I(E)everetteps@everettwa.govi www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 3018 21 st St Everett, WA 98201 PROPERTY TAX#: 00553101300900 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Frances Yocum TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 3018 21st St ci y Everett STATE WA ZIP 98201 OWNER PHONE: (425)327-7485 OWNER EMAIL: FayOCUm@gmail.Com CONTRACTOR NAME: R&R Foundation Specialist CONTRACTOR ADDRESS: STREET 3409 McDougall Avenue, Suite 204 cliv Everett STATE WA ZIP 98201 CONTRACTOR PHONE: (425)760-5077 CONTRACTOR EMAIL: Lauren@rrspecialist.net CONTRACTOR LICENSE#(REQUIRED): RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 PRIMARY CONTACT: ❑OWNER D CONTRACTOR ].OTHER(Please Specify) Pt CCOV COD iN9-/-0E>f CONTACT NAME: CONTACT PHONE: (425)760-5077 ext.a. Lauren Chapman rec t.G-V CDo d,nodor CONTACT EMAIL: Lauren@rrspecialist.net BUILDING INFORMATION Existing Use of Building: SFR Contract Price of Work:$ $10,914.50 Proposed Use of Building: SFR Heat Source: ❑Gas DElectric ❑Other BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: [New ❑Addition ❑Remodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install (3)3 inch helical piles and (1)3 inch concentricalong the western perimeter of the foundation of the residence to lift structure back to practical maximum recovery. Steel channel C6 will be used as needed to spread the load evenly along the foundation. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List 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 I 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.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 State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only t0 Z3/ PERI�11�'1 0,1 t D__ 022q Owner/Authorized Agen;Signature Date (Revised 1011012018)