2222 RUCKER AVE 2020-04-02 - Laserfiche WebLink

MIN PERMIT APPLICATIOI I BUILDIN LIIIIIIIECHANICAL/ PLUMBING /SIGN I.URINKLER/ 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 I(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Onl Please „ PROJECT SITE INFORIVIATIOIF,, ,.> PROJECT SITE ADDRESS: gad,t, oCKeIZ lq U( PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMA'T'ION OWNER NAME: TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET a a- p� `�. (�iz i4 V E_ CITY G V(; IZ,C STATE �)// ZIP 9 a Z 01 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ,_ h IA Soc...)?-Cl; Sty I-vi -erS L LC— CONTRACTOR ADDRESS: STREET /4/03 c'rc K/4 2J) ,/ CITY �f/(f(i �L STATE �f/r' ZIP 98390 CONTRACTOR PHONE: 4/2-5.--,..52160 -4/3 CONTRACTOR EMAIL: elf y. AL.C'XPSC;.00 CONTRACTOR LICENSE#(REQUIRED): F`2.4 S(� �? tG j11,27 OF EVERETT BUSINESS LICENSE#(REQUIRED)„O S PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Z S-5'l cp _Li 3 ��e y ALE:Dc i ?4 0 6-11-- CONTACT EMAIL:CjtG y ( (,-' hv Q(;: pS6,C0$ Existing Use of Building: Contract Price of Work:$ ®.£.d® Proposed Use of Building: Heat Source: ,as 0 Electric DOther BUILDING USE: ❑SFR ❑Townhouse ODuplex ❑ADU ❑Multi-Family-#Units: 2Commercial ❑Accessory Structure Type of Project: ❑New RAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Z AT=Or1/4./ F rti-C- Criil S ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL;PERMIT APPLICATION,,_ r. PLUMBINS� PERMIT A1'PL`icA rIoN . , Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C-Air Handling Units 1/ 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 Ventilation 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 SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression 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.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, and I comply wi State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 41/V? PERM! Thk1 Owner/Aug orized Agent Signa ure Date (Revised 4/15/2019)