4030 RUCKER AVE 2021-04-01 - Laserfiche WebLink

• PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING �G�/ SPRINKLER/ DEMOLITION CITY OF EVERETT PERM SE-RVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:4030 RUCKER AVE PROPERTY TAX#:00582101301700 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: JH KAUSHAL LLC TENANT BUSINESS NAME(Commercial): ARCO AMPM OWNER MAILING ADDRESS: STREET4030 RUCKER AVE ciT" EVERETT STATE WA ZIP 98201 OWNER PHONE: 425.789.1620/206.841.4992 OWNER EMAIL:nareshpkaushal@gmail.com CONTRACTOR NAME:MEYER SIGN CO., INC CONTRACTOR ADDRESS: STREET2608 HWY 99 SOUTH ary MOUNT VERNON STATE WA ziP 98273 CONTRACTOR PHONE:360.424.1325 CONTRACTOR EMAIL:PERMITS@MEYERSIGN.COM CONTRACTOR LICENSE#(REQUIRED):MEYERSC83238 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57310 PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360.424.1325 CHAZ DUGAW CONTACT EMAIL:PERMITS@MEYERSIGN.COM BUILDING INFORMATION Existing Use of Building:RETAIL C-STORE AND FUEL Contract Price of Work: $25000 Proposed Use of Building:RETAIL C-STORE AND FUEL Heat Source: ❑Gas 0Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. Sign ❑Sprinkler ❑Demolition EChange of Use DESCRIPTION OF WORK: REPLACE SIGN FACES FOR GAS PRICE SIGN (NOT LOGO SIGNS)AND REWIRE INTERNAL ILLUMINATION AND NUMBER DISPLAY TO LED. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION 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 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/InserULog Roof Drains Water Heater SPRINKLER/ 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.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. City of Everett Official Use Only PERMIT# Chaz Dugaw otm<° "` .sue�r.o�A� 9 0,.MO0,,.,.s. 0r� 07/24/2020 Owner/Authorized Agent Signature Date (Revised 10/10/2018)