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4418 RUCKER AVE MEDICAL BLDG 2018-01-02 MF Import
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4418 RUCKER AVE MEDICAL BLDG 2018-01-02 MF Import
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Last modified
3/4/2022 1:29:52 PM
Creation date
9/30/2019 2:04:11 PM
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Address Document
Street Name
RUCKER AVE
Street Number
4418
Tenant Name
MEDICAL BLDG
Imported From Microfiche
Yes
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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881 J -FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SIT A DRES PARCEL qTAX I.D. # PERMIT # <br />�D a 7 r a- oaf <br />LEGAL LOT N0. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />UESC. <br />OWNER ADDRESS <br />"_mU:,; Cva3.-e (III I��'`� �� <br />CITYIZIP PHO�E / <br />I <br />TENANT NAME CONTACT FOR PERMI �E <br />_.._ ��11 �1W"1 <br />v'� E-MAIL <br />A RES I�r� N <br />CONTRACTOR r_X,J C__!1`- <br />� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric _Gas _Other <br />WOR'" DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />N0. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink &disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow prevenler <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />_ <br />Roof drains <br />_Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritity that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State ntra�fct/or�s�Law 18.27 RRC/W an/d39B290 WAC. <br />ignature of Owner/Contractor/Authorized Agent ate r <br />
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