Laserfiche WebLink
0 PERMIT APPLICATIONO <br />EVERETT <br />WASHINGTON <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 954 North Park Dr <br />PROPERTY TAX #: 00464700004801 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Gordy Biorg TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET P.O Box 168 <br />c,Tv Marysville STATE WA zip 98270 <br />OWNER PHONE: 425-508-1832 <br />OWNER EMAIL: gb@royrobinson.com <br />CONTRACTOR NAME: Aqua Quip <br />CONTRACTOR ADDRESS: STREET 730 SW 34th St <br />CITY Renton STATE WA ZIP 98057 <br />CONTRACTOR PHONE:206-354-8719 <br />CONTRACTOR EMAIL: jbergstrom@aquaquip.Com <br />CONTRACTOR LICENSE #(REQUIRED): AQUAQQ"812C2 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 62097 <br />PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Jim Bergstrom <br />CONTACT PHONE: 206-354-8719 <br />CONTACT EMAIL: jbergstrom@aquaquip.com <br />BUILDING INFORMATION <br />Existing Use of Building: SFR <br />Contract Price of Work: $ 130,000 <br />Proposed Use of Building. Install Swimming Pool <br />Heat Source: OGas ❑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 ❑Sprinkler []Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />Install In -ground fiberglass swimming pool <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C -Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep, floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />I <br />Roof Drains <br />1 <br />Water Heater <br />SPRINKLER '/ SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />I <br />INo. 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 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. / am the owner, or / am authorized by the owner of this property to perform the work for which application is made, <br />and / comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/j City of Everett Official Use Only <br />PERMIT-",Ih0(a— `L4in <br />Owner/Ad1horiz6d Agent Signature Date (Revised 1011012018) <br />1� <br />