1511 RUCKER AVE 2019-11-07 - Laserfiche WebLink

MN PERMIT APPLICATIOI- BUILDINCECHANICAL/ PLUMBING /SIGN I 14IDRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits 03, r$#ack ink-On1y.Pleasej..: . PROJECT<SITE1NFOR fIATiON. PROJECT SITE ADDRESS: 15 1 1 P oC 2 Ak-E PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ONTA`,C'TI1+lPORI "i'JON. - . . . . OWNER NAME: DEAN 46440 t4cL,A I A}}..f_.Q. TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET I g 11 ip tic Ie-t2 A v F r v EKE IT CITY l fl STATE ggZO I ZIP r OWNER PHONE G-31 -7-nj ZZ OWNER EMAIL: .,,.;.__-__ '2.,.,..a-,may.. , -.«.T .:��: .o• .._ ..•.» w.w.-__;-� w, ._. ,,a,.:,m�.. ixw.w..:.,. ,, »w•. <,,.��.. , _3,u- CONTRACTOR NAME: Ea-t)0 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: S. D CONTACT EMAIL: (7 --- —".. \ BLIiLDLNG 1I+IoOoMATiO . � ', Existing Use of Building: e r-12 Contract Price of ork:$ :007i Proposed Use of Building: SF 2- Heat Source: Gas 0 Electric DOther BUILDING USE:p(SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial Elcessory Structure Type of Project: CI New ❑Addition CI Remodel CI Repair ❑T.I. ❑Sign ❑Sp kler CI Demolition Change of Use DESCRIPTION OF WORK: 14ANOt CAp Li Fir 'FOP- F foNT Po Re-14 FoR A-Ccss I✓oQ U%A*EcL e lkfl1Q. ASSOCIATED BUILDING PERMIT#(if applicable): MEI:HANICAL'PERRM.IT,APPLICATION PLUMBIN PERMiT,APPLICATION;} Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub Combo Boiler Gas Range Clothes Washer Sink-C ercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless — Dishwasher Sji - esidential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain ,,Sink-Utility,laundry,mop Exhaust Fans(Residential) Commerci ntilatior Floor Drain / Toilet Exhaust Hood(Type I) (Not t/AC system) Hose Bibb Urinal Exhaust Hood(Type II) ater Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-S94/ it Water Service(behind meter) Forced Air Systems Other: Medical Water Valves or Fixtures Gas Fireplace/Inse og R3paf rains Water Heater SPRINKL R'I SUPPRESSION,SYSTEh11 /Sewage Ejector or Sump Pump Other: Water Suppressi ystem No.of Heads Chemica ression System 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. f City of Everett Official Use Only Cjvr•.ti T q-20/? PERfjM�# `- \cl " O k, Owner/Authorized Agent Signature Date (Revised 4/15/2019) t 2)