1223 LOMBARD AVE 2025-01-24 - Laserfiche WebLink

4-77 PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (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: 1223 Lombard Everett WA 98201 PROPERTY TAX#:00397223901200 LEGAL for new construction: Short Plat/subdivision Broadway Land Co 1st Add Lot No.12,13 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Mike Gilham TENANT BUSINESS NAME(Commercial): N/A OWNER MAILING ADDRESS: STREET1223 Lombard CITY Everett STATE WA ZIP 98201 OWNER PHONE:415-370-8625 OWNER EMAIL:mgilham2@gmail.COm CONTRACTOR NAME: John Oliver/ Homework Construction Services IIC CONTRACTOR ADDRESS: STREET PO Box 1 149 crry Monroe STATE WA zr, 98272 CONTRACTOR PHONE: 425-941-2687 CONTRACTOR EMAIL: John@homeworkseattle.com CONTRACTOR LICENSE#(REQUIRED): 603-078-769 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)LO be assigned PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-941-2687 John Oliver CONTACT EMAIL: john@homeworkseattle.com BUILDING INFORMATION Existing Use of Building: garage Contract Price of Work: $ 2000.00 Proposed Use of Building: demo Heat Source: OGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex , ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: CI New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ✓❑Demolition ❑Change of Use DESCRIPTION OF WORK: remove failed structure 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) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain 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 I Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System 'No.of Heads Chemical Suppression System INo.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 granting 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 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT � � ,�J 4/17/2019 (D � Owner/Authorized Age ignature Date (Revised 10/10/2018)