1422 RUCKER AVE 2025-01-28 - Laserfiche WebLink

MIMI PERMIT APPLICATION 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 I www.everettwa.gov/permits (Blue of Black Ink Only Plum') PROJECT SITE INFORMATION PROJECT SITE ADDRESS; I41.0 12,O , ..... PROPERTY TAX#: dd�7 G,0 -1 60u7Q LEGAL for new construction: Short Plat/subdivision 06,4 ' Lot No.i�.) (attach copy of long legal description) CONTACT INFORMATION - OWNER NAME:10 ' r- ., TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET K-Lam- 1a--04 �..�,� A' / y ! 1G�c A CITY EY f STATE ,6 ZIP 41,0 OWNER PHONE:26167 I V '7 61 OWNER EMAIL: 65I,8 •loa_V ear 1.V m t-, '1e CONTRACTOR NAME: s 17. V U MA7 '-1) \ \\ ' leyt UL,J _Vili , if k CONTRACTOR ADDRESS: STREET (J1 V (L LC r TY _ CITY \VAI V, " U�1 _ CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) -'' --10 , CONTACT NAME: CONTACT PHONE: 42 . .2 7 (P--- D ` — K RA M CONTACT EMAIL: 12./1/4-D,P'6(0 '" t, e Cc BUILDING INFORMATION Existing Use of Building: .( Contract Price of Work:$ /,-- e7r4 Proposed Use of Building: .r P— Heat Source: Gas DElectric 'QOther — BUILDING USE: f2TSFR ❑Townhouse ❑Duplex ❑ADU ElMulti-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 14+ r AOr r icy 4 optc... —t') -lax(.s tiJC- ASSOCIATED BUILDING PERMIT#(if applicable): 14.1!' r u . - 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 I Clothes Washer Sink-Commercial(3-comp,prep,floor) _ ` Clothes Dryer Heat Pump&Ductless I _Dishwasher ' Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry tito,ryyyp 2. Exhaust Fans(Residential) Commercial Ventilatior Floor Drain j Toilet Exhaust Hood(Type I) (Not Heat/AC system) 1 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 Heat SPRINKLER I SUPPRESSIONSYSTEM 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 aw 18.27 RCW and 296.200A WAC. City of Everett Official Use Only it PERIe �q...loci Ow7:::07 horized Agent ignature Date (Revised 10/10/2018) Vz