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4117 RUCKER AVE 2022-07-27
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4117 RUCKER AVE 2022-07-27
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7/27/2022 11:42:38 AM
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7/27/2022 11:42:24 AM
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Address Document
Street Name
RUCKER AVE
Street Number
4117
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• <br /> PERMIT APPLICATION • <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <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:41 17 RUCKER AVE PROPERTY TAX#:00582101500900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. _ (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ELLIS JOHN C & ETHEL A TENANT BUSINESS NAME(Commercial): REMNANT KING CARPET <br /> OWNER MAILING ADDRESS: STREET4117 RUCKER AVE <br /> ciTi EVERETT STATE WA zip 98203 <br /> OWNER PHONE: (425) 259-4922 OWNER EMAIL: johnandmidge@remnantkingcarpets.com <br /> CONTRACTOR NAME:GS Heating & Cooling LLC <br /> CONTRACTOR ADDRESS: STREET3409 Everett Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-309-6507 CONTRACTOR EMAIL:JOnathan@GSHeating.COm <br /> CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 19685 <br /> PRIMARY CONTACT: ❑OWNER O CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-309-6507 <br /> Jonathan D Farrell CONTACT EMAIL:Jonathan@GSHeating.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:warehouse Contract Price of Work: $2,500.00 <br /> Proposed Use of Building:warehouse Heat Source: OGas ❑Electric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: I(Commercial ❑Accessory Structure <br /> Type of Project: New ❑Addition ❑Remodel ❑Repair T.I.❑ ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Replacing unit heater with like in kind unit <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 /> NC—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 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 1 Unit heater 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 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 Stat ontractors Law 18.27 RCW and 296.200A WAC. <br /> '� City of Everett Official <br /> Use Only <br /> PE I ' 1 (.n I I-D1ci <br /> 11-2-20 <br /> • <br /> 0 eF/Authorized A ent"sign Date (Revised 10/10/2018) <br />
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