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4FTTPERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2126 RUCKER AVE. PROPERTY TAX#: 00439143201900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: CARL & DIANA KING TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 2126 RUCKER AVE. <br /> cm EVERETT STATE WA ZIP 98201 <br /> OWNER PHONE:425.749.0742 OWNER EMAIL: cIking8@comast.net <br /> CONTRACTOR NAME: MASTERDECKS LLC <br /> CONTRACTOR ADDRESS: STREET 16910 59TH AVE NE <br /> ,,T,, ARLINGTON STATE WA ziP 98223 <br /> CONTRACTOR PHONE:36O.454.0708 CONTRACTOR EMAIL: permit@proadminservices.net <br /> CONTRACTOR LICENSE#(REQUIRED): MASTEL836BZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): Y xi• <br /> •QX <br /> }6i– <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR O OTHER(Please Specify) Permit&design Manager � I')C " `-� <br /> CONTACT NAME: CONTACT PHONE:360.454.0708 <br /> Wes LaRocque CONTACT EMAIL:permit@proadminservices.net <br /> BUILDING INFORMATION <br /> ; U <br /> Existing Use of Building: Residence Contract Price of Work:$47,250.00 r 1'eOO.°,12.• <br /> Proposed Use of Building: Residence Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE: OSFR ❑Townhouse EDuplex LIADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New EAddition I1Remodel ❑Repair [ETA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Demo old deck and porch and rebuild a new 2 tier deck in same location on house. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-camp,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:I 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.I am the owner,or I 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 /> _Z.,/ <br /> J - �� PERMIT iI/] —t2, D2) <br /> ,_ __.-. --<-, <br /> —/� 2/20/2019 (/I <br /> Owner/Authorize gent Signature Date (Revised 10/10/2018) <br />