2814 RUCKER AVE 2025-04-07 - Laserfiche WebLink

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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 1(E)PermitSetvices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2814 Rucker Ave. PARCEL#: 00439167001901 CITY Everett STATE WA ZIP 98201 SUITE/UNIT#: --- FLOOR M 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANTIBUSINESS NAME(if non-residential):Marcel IIC LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: /{Qcr.— u—,(, OWNER MAILING ADDRESS: STREET 'o lJ C, ,V6 c,rr Everett STATE WA z,P 98201 OWNER PHONE: �]2 �j'IJLj 1 OWNER EMAIL: 0.k YVI OXCRI I @ Ma i GO fln CONTRACTOR COMPANY NAME:Self-performing Work — i W o(,()`(,L/- al hart i�aAa-l. WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑O OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: -]20.32S , 974-] Sc,otl 4Qk"^R CONTACT EMAIL: SIpojvylgt^ceAPq 9 ma►I urA BUILDING INFORMATION VALUATION OF WORK:$ 3o r°00 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevaiing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING(SISKMvb- VR£TAIL.. PROPOSED USE OF BUILDING: Asslv,4 ( HEAT SOURCE: ❑Gas RElectric ❑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 ©T.I. ❑✓Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: C I�At�fca6 n F crcupAm c V. 'ba r Cn v f-e t— b 9 r , 13 2024 ACKNOWLEDGEMENT 1 have reviewed this application and confirm the information contained herein is true and correct.Work done pu(suanl:latnis i n. s('v?pply 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 Z'Z�� PERMIT# s Z U —Vc�5 Owner/Authorized Agent Signature at (Revised 4/21/2022)