1322 RUCKER AVE 2023-05-31 - Laserfiche WebLink

me in B ILDING PERMIT APPLICATI CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1322 Rucker Avenue PARCEL#: 00438524302100 CITY Everett STATE WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Everett Div R Plat of Lot No.: 21-22 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Gary&Ardis McLean OWNER MAILING ADDRESS: STREET 1322 Rucker Avenue CITY Everett STATE WA zip 98201 OWNER PHONE:(425) 765-8578 OWNER EMAIL: gary_mclean@msn.com CONTRACTOR COMPANY NAME:R Family Remodeling WA STATE CONTRACTOR LICENSE#(REQUIRED):RFAMIFR812QA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): W.1. i v CONTRACTOR ADDRESS: STREET 1035 Montague Avenue ICITY Darrington STATE WA zip 98241 CONTRACTOR PHONE:(425) 750-1314 CONTRACTOR EMAIL:richardruiz@comcast.net PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ✓❑OTHER(Please Specify) Designer/Agent CONTACT NAME: CONTACT PHONE:(206)225-0068 Douglas Almond(NuttyCAD Drafting&Design) CONTACT EMAIL:doug.almond@nuttycad.com BUILDING INFORMATION VALUATION OF WORK:$75,000.00 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Single Family Residence PROPOSED USE OF BUILDING:No Change HEAT SOURCE: ✓❑Gas ❑Electric ❑Other BUILDING TYPE: ✓❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ✓❑Addition ❑Remodel ❑Repair DTI. ❑Change of Use ❑Modular LiPortable ❑Re-roof CI Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Main floor bedroom, bathroom addition 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 f deral,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 Buildin 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 omply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT C.6 07/20/2021 2 A 01 V(o b Ow r/Authorized Agent Sign Date i (Revised 2/8/2021) 5\ \AA:\\kt/t() k•S Vtr k-- \/tEi- k\thlk . 4--.)