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PERMIT APPLICATII <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 l FAX 425-257-8857 l (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or: Black:lnk On1y;Please); _ PROJECTSITE.I,N,FORMATION <br />PROJECT SITE ADDRESS: 914 B 66th PL SE, Everett <br />PROPERTY TAX #: 0066510000010 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />.CONTACT. I NFO RMATI ON` <br />OWNER NAME: Judy Burns TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET3855 NE 90TH <br />crr, SEATTLE STATE WA z,P 98115 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME:BBRR: Paul Bailey <br />CONTRACTOR ADDRESS: STREET 12918 Mukilteo Speedway C23 #364 <br />CITY Lynnwood STATE WA ZIP 98087 <br />CONTRACTOR PHONE:206-356-3551I <br />CONTRACTOR EMAIL:paUl@bbrrllc.com <br />CONTRACTOR LICENSE #(REQUIRED) <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR 0 OTHER (Please Specify) Degenkolb Engineers <br />CONTACT NAME: <br />Mike Bramhall <br />CONTACT PHONE:206 718 1094 <br />CONTACT EMAIL:mbramhall@degenkolb.com <br />BUILDING INFORMATION <br />Existing Use of Building: Residential <br />lContract Price of Work: $20,000 <br />Proposed Use of Building: Residential <br />Heat Source: []Gas l7Electric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ✓❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑✓ Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: like -kind repair to fire damaged duplex. Damaged elements include stud wall framing at chimney, <br />25-30 SF of floor framing, and 35-40 SF of roof sheathing. <br />ASSOCIATED BUILDING PERMIT # (if applicable): IF <br />MECHANICAL <br />PERM. <br />1T APPLICATION <br />, ° , <br />_ _ 'PLUMBING PERMIT <br />APPLICATION_ .; <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />Roof Drains <br />Water Heater <br />$PItINKLER /:SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />1 <br />117,37. of Heads <br />Chemical Suppression System <br />I <br />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 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 l am authorized by the owner of this property to perform the work for which application is made, <br />and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />4/22/20 <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PER 2©Dq "' w <br />(Revised 1011012018) <br />