2525 RUCKER AVE 2023-06-22 - Laserfiche WebLink

IIM • PERMIT APPLICATION MI BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ 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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION cd054.; Z 7'sl,?ao/ ciao PROJECT SITE ADDRESS: %`J Z r�v1 G/ c v /4 V-e PROPERTY TAX#: vu5'(o 2 ys4. .6'0/y o OJ LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: �'e-t l 1/ei y'Oil ,-yy/L' TENANT BUSINESS NAME(Commercial): �rl/GE//�C,7 / !i/)) 1 OWNER MAILING ADDRESS: STREET /' . C': , 7 / 7 CITY �c-(/f/e__ STATE /'t/I/- ZIP ` 8, /6, 7 OWNER PHONE: f LL OWNER EMAIL: CONTRACTOR NAME: � e_;,v.1 n IA,A Co LA S-f�'ti L41'o✓1 CONTRACTOR ADDRESS: STREET 97 ?7 CJ 0 l�1 e_Sf v ,,,+ 41re ,I //II A CITY Y C V`�> � STATE VU - ZIP V CCU CONTRACTOR PHONE: q Z y' 2S 1 et I '7 I CONTRACTOR EMAIL: } (�- A___---)CONTRACTOR LICENSE#(REQUIRED): N LI4L� 3y 3, Lb CITY OF EVERETT BUSINESS LICENSE#(REQUI D): ` -V b 3 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR XOTHER(Please Specify) /i Yam-Lj, rv��f C ACT NAME: J CONTACT PHONE: '/ /�� Z.c� Z - </S L 1 ZcI4�J/&/{ A.c�l.r✓✓ CONTACT EMAIL: ,d ys,,�`�/��€' vt3/ ,.��,,,. ,;'/ �L/u ve. co :,.t BUILDING INFORMATION Existing Use of Building: %- 3 / A Contract Price of Work:$ S , C C> cC Proposed Use of Building: /9— / 7. 7 Heat Source: ❑Gas ,Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ,N51.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: , -le/ /J7 b ✓ c t fr ��/` /,,c / //DDd ice ki- c%C)/eCy/ /.1 fL i e f�1 ASSOCIATED BUILDING PERMIT#(if applicable): I WP'd 3> lark h1/00 11 �rnoci _ 1 t- t I 6 ,6 -5se� '}LKJr{'` 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 I 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 Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only l-:1-4/ ---/ / Pr17-1_0J d b V Owner/Authorized Agent Signature Date (Revised 10/10/2018)