3226 RUCKER AVE REAL PROPERTY FUNDING GRP 2021-12-22

® PERMIT APPLICATIO BUILDINOMECHANICAL I PLUMBING I SIG PRINKLER/ DEMOLITION EVERETT CITY 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 I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 322(c i2 Li(kr( Ave 1�(k\ qcb ZD I PROPERTY TAX#: Q o9 3 53 z t5-c-c° LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) -} (J CONTACT INFORMATION OWNER NAME: f Leal C( F` '-12(Gts �vb Jr)Lit TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET .3-5(JL) R-i;v C'(4 LA/4,3wc_ (y CITY 3(ck 1'1 `-12 L.--,I)L.--,I)STATE (.. ZIP 9& _ ii S OWNER PHONE: 2-0( q.;0 O3't":- OWNER EMAIL: ry ke r-Cv r p care m (.0 w, CONTRACTOR NAME: ii-etk I I w r rl G L'LC CONTRACTOR ADDRESS: STREET 5-1TD 1 j €Ale. ( - 14'`4. Ni CITY `mot ck.` -k_ STATE UL ` ZIP !5r CONTRACTOR PHONE: 2.--cJ(c, C'.2/ t'' Y)- CONTRACTOR EMAIL: f -C-C`' T pare :L ""' CONTRACTOR LICENSE#(REQUIRED): -PG(,(Pe I` SSA NJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): b OCI PRIMARY CONTACT: .OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Z,J(p 13 v O`3- -- V_‘/ ' p , '" CONTACT EMAIL: C 7 ke-re r ply rf_, L v,--\ BUILDING INFORMATION -— � s -�. Existing Use of Building: 0L3P k K Contract Price of Work:$ / Proposed Use of Building: 43,13.C9)X Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse XDuplex DADU ❑Multi-Family-#Units: \` ❑Commercial ccessory Structure Type of Project: ❑New ❑Addition ❑Remodel 11Repair ❑T.I. ❑Sign ❑Sprinkler ��`-O.Dernotit n ❑Change of Use DESCRIPTION OF WORK: k - 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/Insert/Log 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 Cont ctors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 1 i13 � � � P (bco� -,..- ofCn Owner/Authorize gent Signature Date (Revised 4/15/2019)