521 51ST ST SW 2017-03-10 - Laserfiche WebLink

To: Page 2 of 2 2016-10-11 22:12:48 (GMT) 18884000383 From: Deborah Shields PERMIT APPLICATION #111111P01 BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 j FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue"ar.Black lnk:Only Ple"ase)' PROSECT.Sit .INFORMATION;. PROJECT SITE ADDRESS: 521 51St St SW PROPERTY TAX#: 29043600405000 LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) ;CONTACT INFORMATION OWNER NAME: Chris Erickson TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 521 51st St SW Everett STATE WA zIE 98203 OWNER PHONE: (425) 210-3816 OWNER EMAIL: CONTRACTOR NAME: The Home Depot At Home Services CONTRACTOR ADDRESS: STREET 3600 Lind Ave SW#150 CITY Renton STATE WA zip 98057 CONTRACTOR PHONE: 800-381-5699 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): HOMED**972RQ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): — PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ,❑OTHER (Please Specify) Agent CONTACT NAME: CONTACT PHONE: 360-945-2787 Naida Khan/Northwest Permit Inc CONTACT EMAIL: naida@nwpermit.com BUiLDING`PERNIIT APPLICATION" ";, Existing Use of Building: Contract Price of Work:$ 16,965.52 Proposed Use of Building: Heat Source: ❑Gas DElectric DOther Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. DSign DSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Replacing 36.3 squares of comp. roofing. No plywood replacement. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT"APPLICATION PLUMBING"PERMIT APPLICATION Type of Project: New _ Addn _Alteration Repair Type of Project: New _Addn ^Alteration _Repair Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures #of List of 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: SPRiNKLERI SUPPRESSION SYSTEMA ` , "< 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 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. Dyanna of Everett Official Use Only Dyanna Sconzo DigitallysignedbyDyannaSconzo PERMIT# I (� Owner/Authorized Agent Signature Date 1 Date:2016.10.1 1 15:10:43 0700' 1 0 0 0 I ll (Revised 9/2.. 016)