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0 PERMIT APPLICATION <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 FAXA95_9F7_RUG7 iiM H _..___...____, <br />,"/.....,.. 'PoN wuvcic a.yuv1 www.evereLma.gov/permits <br />(Blue or Black ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:810 33rd St Everett, WA 98201 <br />PROPERTY TAX #:00583978300300 <br />LEGAL for new construction: Short Platfsubdivision Lot No.y3_ (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Wendy Fellers TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: ITREET810 33rd St <br />clTv Everett STATE WA zip 98201 <br />OWNER PHONE: <br />OWNER EMAIL:WendyfellerS@hotmaii.Com <br />CONTRACTOR NAME:Back Forty Construction, LLC <br />CONTRACTOR ADDRESS: STREEr27419 1 18th St SE <br />CITY Monroe <br />STATE WA ZIP 98272 <br />CONTRACTOR PHONE: 4255-232-3732 <br />1CONTRACTOR EMAIL: Back4OC@msn.COm <br />CONTRACTOR LICENSE #(REQUIRED): BACKFFC914P6 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 556480 <br />PRIMARY CONTACT: ❑ OWNER El CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE:425.232-3732 <br />Shanna Clothier <br />CONTACT EMAIL:Back Forty Construction <br />BUILDING INFORMATION <br />Existing Use of Building:Garage lContract <br />Price of Work: $12,000.00 <br />Proposed Use of Building: Garage lHeat <br />Source: ❑Gas ❑Electric ❑Other None <br />BUILDING USE: IDSFR ❑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: Remove Flat roof from East half of Adjoining Garage and install Trusses. Re -enforce exsting garage as <br />needed to Support new roof. Uncooperative Neighbors will not do anything with their side. <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />'- <br />PLUMBING PERMIT <br />APPLICATION-` <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />L6t of Fixtures <br />Fixture <br />List of Fixtures <br />Fixture <br />List of Fixtures <br />Count <br />Count <br />A/C —Air Handling Units <br />Gas Piping <br />Backflow Preventer (inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Clothes Dryer <br />Gas Range <br />Heat Pump&Ductless <br />Clothes Washer <br />Dishwasher <br />Sink -Commercial (3-comp,prep,floor) <br />Duct System (Re ddel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Residential (kitchen, bath, bar) <br />Sink -Utility, laundry, mop <br />Exhaust Fa (Residential) <br />Commercial Ventilatio <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhau_§kflood (Type 1) <br />Hose Bibb <br />Urinal <br />E ust Hood (Type II) <br />xhaust Hood (Residential) <br />Water Heater <br />Wood Stove <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Forced Air Systems <br />LE <br />Other: <br />Interceptor-Sand/Oil <br />Medical Gas <br />Water Service (behind meter) <br />Gas Fireplace/Insert/LogI <br />Roof Drains <br />Water Valves or Fixtures <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />Nc. of Heads <br />Chemical Suppression System <br />INo. <br />of Heads <br />ACKNOWLEDGEMENT <br />1 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 I am authorized by the owner of this property to perform the work for which application is made, <br />and I comply with the ?tate Contractors Law A27 RCW and 296.200A INAC. <br />City of Everett Official Use Only <br />% a /l l PERMi r l/2 V <br />d Agent Signature Date (Revised 1011012018) lJ J <br />