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PERMIT APPLICATIO <br /> BUILDING ECHANICAL I PLUMBING I SIGN I RINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> ' ' 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8857 (E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> (Sllw or Slack Ink Only PIna..) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:320 S Cabot Road PROPERTY TAX#:003933-000-067-00 <br /> LEGAL for new construction: Short Plat/subdivision Beverly Hills Division 5 Lot No.67 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Marc Fogg TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 318 S. Cabot Rd <br /> c,N Everett STATE WA ZIP 98203 <br /> OWNER PHONE: 425.308.5619 OWNER EMAIL:fogg.marcgmail.com <br /> CONTRACTOR NAME:LEXAR Homes <br /> CONTRACTOR ADDRESS: STREET 3721 116th Street NE, Ste 9 <br /> CITY Marysville STATE WA ZIP 98271 <br /> CONTRACTOR PHONE:360.657.1968 CONTRACTOR EMAIL:walkerconstructionbuilder@gmail.com <br /> CONTRACTOR LICENSE#(REQUIRED):LEXARH*850NC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):t <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑,r OTHER(Please Specify) Smith Land Development Services <br /> CONTACT NAME: CONTACT PHONE:425.238.6324 <br /> Stacy Smith CONTACT EMAIL:stacy@stacysmith.net <br /> BUILDING INFORMATION <br /> Existing Use of Building:Existing SFR to be removed Contract Price of W k:$190,0 00 1p <br /> Proposed Use of Building:Single Family Residence Heat Source: OGas is ❑Other <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: JNew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ©Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Removal of existing SFR, construction of New SFR <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units 4 Gas Piping Backflow Preventer(Inside Bldg) 2 Shower,Tub,or Combo <br /> Boiler I Gas Range _ I Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> I Clothes Dryer I Heat Pump&Ductless I Dishwasher 5 Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain 1 Sink-Utility,laundry,mop <br /> 3 Exhaust Fans(Residential) Commercial Ventilation Floor Drain 2 Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) 2 Hose Bibb Urinal <br /> Exhaust Hood(Type I!) 1 Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> I Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> I Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> 1 Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump i Other: <br /> Water Suppression System I No.of Heads <br /> Chemical Suppression System I No.of Heads <br /> 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 <br /> current f=• _,s a e, _ - al law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Build !Official before•=ing • ' _• •= any circumstance.lam the owner,or/am authorized by the owner of this property to perform the work for which application is made, <br /> and comply 'h the %_ _ •, actors La '8. RCW and 296.200A WAC. <br /> i City of Everett Official Use Only <br /> /4// / PERMITOwn= zed Agent ature D e (Revised 10/10/2018) <br />