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® PERMIT APPLICATION <br /> imi <br /> BUILDINC.ECHANICAL / PLUMBING / SIGN RINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICE <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3226 Rucker Ave Everett 98201 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Roosevelt Holdings LLC TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 7500 Roosevelt Way NE CITY Seattle STATE VV,A/ <br /> A ZIP 98115 <br /> OWNER PHONE: 206-930-0377 (OWNER EMAIL: ryker@rpare.com <br /> CONTRACTOR NAME: Real Property Funding Group LLC <br /> CONTRACTOR ADDRESS: STREET 7500 Roosevelt Way NE <br /> CITY Seattle STATE WA ZIP 98115 <br /> CONTRACTOR PHONE: 206-930-0377 (CONTRACTOR EMAIL: ryker@rpare.com <br /> CONTRACTOR LICENSE#(REQUIRED): REALPPF855N5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (.(,CC Cif <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER (Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-930-0377 <br /> Ryker Young CONTACT EMAIL: ryker@rpare.com <br /> BUILDING INFORMATION <br /> Existing Use of Building: Duplex Contract Price of Work: $ 30,000 <br /> Proposed Use of Building: Duplex Heat Source: ElGas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse Pi 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: Replace 3 exterior doors, Replace all windows (some framing alterations necessary in places), <br /> reinsulate in areas exposed by plumbing, mechanical, electrical work, all new sheetrock throughout over existing walls <br /> (no structural alterations, additions or layout changes,to the the existing building envelope) <br /> ASSOCIATED BUILDING PERMIT#(if applicable): B1906-016, X1906-001, E1908-052 <br /> — <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-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 Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> — <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 Gas Fireplace/Insert/Log <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> _ <br /> Roof Drains Water Heater <br /> Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC, <br /> SI'D 1'2'0 City of Everett Official Use Only <br /> PERMIT# / <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />