2103 106TH ST SW 2019-08-14 - Laserfiche WebLink

PERMIT APPLICATION ..y.-' BUILDING IECHANICAL/ PLUMBING / SIGN 'RINKLER / DEMOLITION Ntif 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.everettwagov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2103 106th Street SW,Everett,WA 98204-3633 PROPERTY TAX#: 005354-000-020-02 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Robert B. &Dixie M.Jenson TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2103 106th Street SW ciTY Everett, STATE WA ZIP 98204-3633 OWNER PHONE: (480)205-6051 OWNER EMAIL: jensonrb@gmail.com CONTRACTOR NAME: Amador's Home Remodeling CONTRACTOR ADDRESS: STREET P. O.Box 3051 crn' Everett STATE WA ZIP 98213 CONTRACTOR PHONE: (206)712-3711 CONTRACTOR EMAIL: amadorshomeremodeleling56@gmail.com CONTRACTOR LICENSE#(REQUIRED):AMADOHR851DE CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 7�I`' ^� PRIMARY CONTACT: ® OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Robert B.Jenson CONTACT PHONE:(480)205-6051 CONTACT EMAIL: jensonrb@gmail.com BUILDING PERMIT APPLICATION Existing Use of Building: Single Family Resident Contract Price of Work: $20,000.00 Proposed Use of Building: Single Family Resident Heat Source: ❑Gas 0 Electric ElOther Ductless Heating Building Type: El SFR-Detached ❑SFR-Attached El Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New ❑Addition ElRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Change 4 bedroom 1 1/2 bath home to a 3 bedroom 2 1/2 bath home by converting small bedroom next to Master Bedroom into a Master Bathroom. Demo Closet space in Master Bedroom and small bedroom. Build new Master Bedroom closet on east wall of Master Bedroom. Close off door to small bedroom and move opening from Master Bedroom to new Master Bathroom. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn X Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump 1 Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater 1 Bathtub Urinal Gas Piping Boiler 2 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration 1 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: 2 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.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, andJ.-cam ith the State Contractors Law 18.27 RCW and 296.200A WAC. ry City of Everett Official Use Only rV.(: ,° PERM #! 450 '''''DD st Owner/Authorized Agent Signature Date (Revised 9/23/2016)