129 75TH ST SW 2019-08-13 - 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 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 129 75TH ST SW EVERETT WA 98203 PROPERTY TAX#: 00792400003500 LEGAL for new construction: Short Plat/subdivision RIDGE LANE Lot No. 35 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: DIANNE CLOUD TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 15214 25TH AVE WEST cr' LYNNWOOD STATE WA ZIP 98087 OWNER PHONE: 425.409.1365 OWNER EMAIL: CROUDSAN2000@FRONTIFR COM CONTRACTOR NAME: BROOK &COMPANY CONTRACTOR ADDRESS: STREET 8530 218TH ST SW cin EDMONDS STATE WA ZIP 98026 CONTRACTOR PHONE: 425.778.9893 CONTRACTOR EMAIL: DAN@BROOKANDCOMPANY COM CONTRACTOR LICENSE#(REQUIRED): BROOKC*99282 CITY OF EVERETT BUSINESS LICENSE#(REQUlkED) Slq7,.." PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR CZ OTHER(Please Specify) ARCHITFCT CONTACT NAME: CONTACT PHONE: 206.547.7933 MARK PARKER,MARK PARKER ARCHITECTS CONTACT EMAIL: MARK@MARKPARKERARCHITECTS.COM BUILDING PERMIT APPLICATION Existing Use of Building: SINGLE FAMILY RESIDENCE Contract Price of Work:$ 2®I 000.09 Proposed Use of Building: SINGLE FAMILY RESIDENCE Heat Source: 5:1Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑industrial Type of Project: ONew ❑Addition ( Remodel ❑Repair ❑T.I, ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: INTERIOR REMODEL OF EXISTING SINGLE FAMILY RESIDENCE 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 #of List of Fixtures #of List of Fixtures #°f List 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 fL-i Gas Piping Boiler 1 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration 1 Shower Floor Drain 1 Gas Fireplace Wood Stove 1 Kitchen Sink&Disposal Grease Trap 1 Gas Range Ducting 1 Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas 1 Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water I No.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.lam 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 aw 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERM c503-4 3 C 2 0ner/Authorized Agent Signature Date (Revised 9/z3/2016)