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910 RUCKER AVE 2020-04-02
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910 RUCKER AVE 2020-04-02
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4/2/2020 11:28:12 AM
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4/2/2020 11:28:02 AM
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Address Document
Street Name
RUCKER AVE
Street Number
910
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PERMIT APPLICATION■ <br /> BUILDING I MECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 l FAX 425-257-8857 I(E)everettepsr@everettwa.gov www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:910 Rucker Ave., Everett WA 98201 PROPERTY TAX#:00553217303000 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Jacob Kincaid TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 910 Rucker Ave <br /> cn-y Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 214-207-5581 OWNER EMAIL:jacob.a.kincaid@gmail.com <br /> CONTRACTOR NAME:R&R Foundation Specialist <br /> CONTRACTOR ADDRESS: STREET 3409 McDougall Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-760-5077 CONTRACTOR EMAIL:IeeSa@rrspecialist.net <br /> CONTRACTOR LICENSE#(REQUIRED):RRFOUFS829DA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58143 <br /> PRIMARY CONTACT: 0 OWNER D CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-760-5077 ext 2 <br /> Leese Cronin CONTACT EMAIL:leesa@rrspecialist.net <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$19 225.00 <br /> Proposed Use of Building:Foundation Repair Heat Source: OGas DElectric DOther <br /> BUILDING USE: CISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: :New ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Crew will install (6)3"Helical Piles to Stabilize Foundation. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fb ure Fixture Fixture <br /> count List of Fixtures count List of Fixtures Count Count <br /> of Fixtures Courrt List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System I No.of Heads <br /> ACKNOWLEDGEMENT:!have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance.!am the owner,or l am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# .ji //ID) o <br /> 1,4/Authorized ent Signature Date (Revised 10/10/2018) <br />
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