3927 RUCKER AVE BASE FILE 2019-09-24

OLT 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 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 3927 Rucker Ave Everett, WA 98201 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Gunderson BLDG TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3927 Rucker Ave CITY Everett STATE WA zip 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Burns Fire Protection System INC. CONTRACTOR ADDRESS: STREET P.O. Box 1110 CITY Granite Falls STATE WA ZIP 98252 CONTRACTOR PHONE: 360-691-2235 CONTRACTOR EMAIL: Adminasst@burnsfire.com CONTRACTOR LICENSE#(REQUIRED): BURNSFP841 DU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54660 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-905-5780 Keith Kyle CONTACT EMAIL: Keith@burnsfire.com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ 5500 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: I7Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair C/7T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Burns Fire to modifying an existing system to provide coverage to exterior canopies at entries. 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 #of List of Fixtures #of 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/SUPPRESSION SYSTEM 1,,.0 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 3/y/2 PERI-1 \� (5°2— Owner/ft O2 Owner/ u rued Agent gnature (Revised-1 ,/239‘6) 99//23/22016)