4503 RUCKER AVE 2023-06-22 - Laserfiche WebLink

Elm PERMIT APPLICATIO ni, BUILDING ECHANICAL/ PLUMBING /SIGN RINKLER/ 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: " l Co-3 V_ucAke T (J4Je__ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) r CONTACT INFORMATION OWNER NAME: (c..Lc,...j (f ,J• T I TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET ( 5 C)v`J,C,C.ve___ CITY W A-,\ STATE0(2? (-Pet._(-Pet._ ZIP 1 e CJ OWNER PHONE: 90c, q/� S 7011 OWNER EMAIL: C o.tiA-q,. -t e., te,.....\ . / CONTRACTOR NAME: 7L)ut •C 7--- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ariTiVNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT1 NAME: CONTACT PHONE: a 0., o f L( S 7 a l u� �� U`rtC9/�l '� CONTACT EMAIL: ,/` _�l l ek(MCCq,,...A.& BUILDING_ INFORMATION } Existing Use of Building: S ! _ Contract Price of Work:$ 'zjC,7 Proposed Use of Building:_� 5 P-- E� Heat Source: ❑Gas EtE is ❑Other L95 BUILDING USE: FK ❑T•wnhouse ❑Dyplex ❑ADU El -#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New a-tA. •n agemodel ❑Repair DTI. ❑Sign ❑Sprinkler Cl Demolition ❑Change of Use DESCRIPTION OF WORK: cr1/41„,_ ,/,^. C �t S F c \ ._,Vc.L c r,S, 1( k- 11�5 b., ASSOCIATED BUILDING PERMIT#(if applicable):l D a 0"'L" 010 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 I Sink-Commercial(3-comp,prep,floor) l 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 1 Exhaust Hood(Type I) (Not Heat/AC system) k Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair l Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/InserULog 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 bein 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 com y it the Sta ontractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# , et' Owner/Authorized Agent Signature ate (Revised 4/15/2019)