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. PERMIT APPLICATION. <br /> 11.1 <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3402 Shore Ave Everett, WA 98203 PROPERTY TAX#:00571700700500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Lacey Maloney TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET3402 Shore Ave <br /> cm Everett STATE WA ZIP 98203 <br /> OWNER PHONE: (914) 500-3763 OWNER EMAIL:IaCeym02@gmall.COM <br /> CONTRACTOR NAME:R&R Foundation Specialist LLC <br /> CONTRACTOR ADDRESS: STREET3409 McDougall Ave suite 204 <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:(425)760-5077 CONTRACTOR EMAIL:info@rrspecialiSt.net <br /> CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR D OTHER(Please Specify) Project Coordinator, R&R <br /> CONTACT NAME: CONTACT PHONE: 425) 248-8813 <br /> Lauren Chapman CONTACT EMAIL:lauren@rrspecialist.net <br /> BUILDING INFORMATION <br /> Existing Use of Building:SFR Contract Price of Work: $16,608.25 <br /> Proposed Use of Building:SFR Heat Source: DGas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Sign ❑Sprin er ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install (8) 3" helical piles along the Southeastern corner and Northwestern corner along the perimeter of <br /> the residence to lift structure back to practical maximum recovery. Install (1)6x6 post with adjustable base and angle iron as <br /> needed to aid in lifting and stabilizing the residence. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> List of Fixtures List of Fixtures Count List of Fixtures Count List of Fixtures <br /> Count Count <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER /SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.of Heads <br /> ACKNOWLEDGEMENT:/have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or/am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 10/10/19 P R IV--Dt,V O ` <br /> wner/Authorize Agent Signature Date (Revised 10/10/2018) <br />