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EVERETT <br />WASHINGTON <br />PERMIT APPLICATION • <br />BUILDING /t C ANICAL I PLUMBING / SIGN I SPRINKLER I 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:3608 Rucker Ave,. Everett WA 98201 <br />PROPERTY TAX #:00451401302800 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMiTI®N <br />_ <br />OWNER NAME: 3608 RUCker Ave, LLC TENANT BUSINESS NAME (Commercial): Rucker Remodel <br />OWNER MAILING ADDRESS: sTREETP.O,BOX 1 094 $ <br />CIrY Woodinville STATE WA ZIP 98072 <br />OWNER PHONE: 425.244.0007 <br />OWNER EMAIL:ismaii.seattle@gmail.com <br />CONTRACTOR NAME: Owner/TBD <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: El OWNER ❑ CONTRACTOR OTHER (Please Specify) <br />CONTACT NAME: <br />Ismail Mohammad <br />CONTACT PHONE:425.244.0007 <br />CONTACT EMAIL: ismail.seattle@gmail.com <br />BUILDING INFORMATION' <br />Existing Use of Building: SFR <br />Contract Price of Work: $65,000____ <br />Heat Source: OGas ❑Electric 00ther <br />Proposed Use of Building V P X <br />BUILDING USF UTownhouse lex ❑ADU ❑Commercial Accessory Structure <br />Type of Project: ❑—N^�ew— emod []Repair ❑T.I. ❑Sign GSprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: Remodel: Basement . Main floor and Attic floor addition of <br />bathroom and dormer in attic. Demolition of stairs to basement. S� 7Lb %J VPLA,X <br />ASSOCIATED BUILDING PERMIT (if applicable): W" <br />MECHANICAL PERMIT <br />APPLICATION <br />_ <br />PLUMBINGPERMIT APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />OU <br />List of Fixtures <br />Fixture <br />Count <br />List of F' ures <br />A/C —Air Handling Units <br />3 <br />Gas Piping <br />flow Preventer (Inside Bldg) <br />4 <br />Showorl,15ccr Combo s <br />oiler <br />3 <br />Gas Ran <br />3 <br />Clothes Sher <br />Commercial (3-comp,prep, focr) <br />3 <br />Clo Dryer <br />3 <br />Hea mp&Ductless <br />3 <br />Dishwasher <br />Sink -Residential (kitchen,bath, bar) <br />Duct Syste emodel) <br />efrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />4 <br />Exhaust Fans (Re ntial) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />4 <br />Toilet _ <br />Exhaust Hood (Type 1) <br />"I <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type I <br />Water Heater <br />Interceptor-Gre <br />Waste/Water Piping Repair I <br />3 <br />Exhaust Hood ( Idential) <br />WQod Stove <br />Intercept Qpeland/Oil <br />3 <br />Witor Service (behind meter) <br />Forced Ai sterns <br />Other: <br />Me I Gas <br />Water es or Fixtures <br />— <br />_ <br />G replace/InserULog <br />R ' s_ <br />�3 <br />Water Heater <br />IRV`LER / SUPP€tIES <br />lWeer <br />SIGN SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Suppression System <br />Chemical Suppression System <br />No. of Heads <br />No. of Heads <br />f i <br />ACKNOWLF_DGEMENT I have reviewed this application and confirm the informahon 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 it only authorizes approved won< and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under a ircumsta e. 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 Skte Contractors Law 18.27 R-0w an 296.200A WAC. <br />City of Everett ffi "use Only <br />�PERMI <br />to D to (Revised 1011012018) <br />z <br />