6930 CARSON RD 2024-02-09 - Laserfiche WebLink

MIMI 0 PERMIT APPLICATION• 1112 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:6930 Carson Rd. PROPERTY TAX#:0039330000700 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Taylor & Ana Southworth TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET6930 Carson Rd. CITY Everett STATE WA ZIP 98203-5039 OWNER PHONE: 503-931-1274 OWNER EMAIL:annabaSSOUs@Corban.edU CONTRACTOR NAME: Agnew Homes, LLC CONTRACTOR ADDRESS: sTREE-11106132nd St NE cITr Arlington STATE WA zip 98223 CONTRACTOR PHONE: --1601 ACTOR EMAIL: ,k G� CONTRACTOR LICENSE#(REQUIR ). YERETT BUSINESS LICENSE#(REQUIRED): C7 � 1 ( PRIMARY CONTACT: 0 OWNER 0 C NTRACTOR 0 OTHER(Please Specify) Designer CONTACT NAME: CONTACT PHONE:425-209-7600 Larry Thibeauit CONTACT EMAIL:rsalarry@hotmail.com BUILDING INFORMATION Existing Use of Building:SFR Contract Price of Work:$34,000 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 ❑Repair ETA. ❑Sign ❑Sprinkler ['Demolition ❑Change of Use DESCRIPTION OF WORK: Bathroom & Office addition, plus a covered porch 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 A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) 1 Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher 1 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility, laundry, mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain 1 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'g7anting 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 R W and 296.200A WAC. i City of Everett Official Use Only (/ PEI3S#^ _ f O Larry Thibeault �e 202L02Oby0La Thib ault Z 3 Z021 LJ—�' l�J Owner/Authorized Agent Signature Date (Revised 10/10/2018) '/z