825 RUCKER AVE 2019-09-24 - Laserfiche WebLink

PERMIT APPLICATION BUILDING /MECHANICAL I PLUMBING/SIGN I SPRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.gov/permits iRtaa,o Black Ink_Only,Pleasa).,.; ,. P'RL JECT:SITE,IgIFORMAT.IQ .- PROJECT SITE ADDRESS: 6 Z /at 0.- 'Gti.Q PROPERTY TAX#: r/ LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) i.++ .. CT INFORMATION.. ,... .. OWNER NAME: m lyie'4 4.41'Y.411►O- ,�,��TEN_�ANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 3 2 S � ciak) ACA.A. CITY C-1„A-en-jr( STATE u) 4 ZIP ?g2-4, 1 OWNER PHONE: I/42-5/ 25 0/4:,...Z J9WNER EMAIL: fJ1Y1C Ai A f e�n.a o . e CONTRACTOR NAME: /J-rVCJL=20.507U ---Ci i(le ea.....„, CONTRACTOR ADDRESS: STREET,^�P.) �7 l -O4 ckyttAi CITY ¢¢77•I'Lj.z.)1..Q STATE K,/q ZIP Ff 2 / CONTRACTOR PHONE: 7-`j 9-- 467 f' CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): 4/0e:1-e-32—/ feol L7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): �fV 33 PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: le05 25 f C f U7 Im Me-A ) e VVt 44.4- CONTACT EMAIL: 'l y)1c"Del, vrn- ) eicl . Cdr,.. IB011LbIN6 11siPQRMAttIONPrY ... �' 3 Existing Use of Building: ll6yy�,,{ . Contract Price of Work:$ '.5.5-C 0 Proposed Use of Buil 'ng: ,S'C4-0^.0— Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: FR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: El New ❑Addition model ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: PI --4.(./' s Lv V1-e...iffrG�•-�-o . C Alec,,- r t �Ki s�e-.7 Y ° / ASSOCIATED BUILDING PERMIT#(if applicable): ,'..,.. jMECHANICAL„PERMIT APPLICATI4ONAV .. >a .,PLUMBING PER IT,A P4UCAT"O4 . , FixtureFixture Fixture Fixture Count List of Fixtures Count � List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater - SPRINKLER I SUPPRESSION SY#0M, ,.,, Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads , 2. Chemical Suppression System No.of Heads. / 91 J5 f< 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 b hg 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 wit State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only f yYl e4,AA.Gc t� 8 ' q 12_0 ( t t PERMIT G_d S Owner/Authorized Agent Signature Date (Revised 4/15/2019) o