4807 BLACK FOREST LN 2017-01-13 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits 4807 B1ack Forest Lane LEGAL for new construction: Short PlaUsubdivision PROJECT SITE INFORMATION AX #: 29053100305100 No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Pranklin Plinn TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTReer 4807 I�lack Forest I,ane arr �verett srATe WA ziP 93203 OWNER PHONE: 425 345-6624 OWNER EMAIL: CONTRACTOR NAME: McBride Construction CONTRACTOR ADDRESS: srReeT 224 Nickeron Street cirv Seattle sTnTe �VA ziP 98109 CONTRACTOR PHONE: 206-549-0436 CONTRACTOR EMAIL: james@mcbrideconstruction.com CONTRACTOR LICENSE #(REQUIRED): MCBRICR099JZ CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR � OTHER (Please Specify) Engineer CONTACT NAME: CONTACT PHONE: 253-833-5557 Jesse Binford CONTACT EMAIL: jbinford@bcie.net BUILDING PERMIT APPLICATION Existing Use of Building: SFF Contract Price of Work: $� Proposed Use of Building: SPR Heat Source: �Gas ❑Electric ❑Other Building Type: �SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel �Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Retrame south�vesc corner wall and Urick facade at southwest corner of garage. ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION n/a PLUMBING PERMIT APPLICATION Il/a Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair # of List of Fixtures # of List of Fixtures # of Lisf of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C —Air Handling Units Heat Pump Toilet Backflow Preventer (Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory (Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink & Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: SPRINKLER 1 SUPPRESSION SYSTEM Number 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 comp/y 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 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. � � ��^r�� Z � �� Owner/Authoriz�9g�t SignaturE ' Date City of Everett Official Use Only PERMIT # ` � � _ �� 1 (Revised 10/12/2015) ' L� �t I lo��`�-� Z