1332 RUCKER AVE 2016-10-04 - Laserfiche WebLink

�� I�►� , - � � PERMIT APPLICATION� BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � wv,nv.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADD ESS: . PROPERTY TAX #: 3_� � ' � r � �v � LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: CU �' SU TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTReET `�32 �L Y� t- `� a rv � v' e ��2.., sTnTE �� zia l; I �(% OWNER PHONE: � 2,�j —��j� '�' �j �� OWNER EMAIL: CONTRACTOR NAME; �- � � ' (�� S�C, � � � f ' G L \ - CONTRACTOR ADDRESS: srREer �U `1 J� yf�,,� �J t CIT1' S Q 1\�j!� STATE � ZIP Z�k% CONTRACTOR PHONE: 2 � " �j —� �, � CONTRACTOR EMAIL: U f � 1�,r . �� • ,f"\ CONTRACTOR LICENSE #(REQUIRED): \ �S �� i CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): O J`q:.�J � PRIMARY CONTACT: L�'6WNER ❑ CONTRACTOR ❑ OTHER (Please Specify) � ��,-i'11 t� CONTACT NAME: CONTACT PHONE: '� �_ ?Jtti �--2C� ` L CONTACT EMAIL• � r �,. r, _�� j1� BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ Ci v��`�` Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: v��l �ti � l�v � Y`�� (,� �'G�c�Y� � ASSOCIATED BUILDING PERMIT # (if applicable): PLUMBING PERMIT APPLICATION Type of Project: _New _Addn _Alteration _Repair # of Lisf of Fixtures # of List of Fixtures Fixfures Fixiures Toilet Backflow Preventer (Inside Bldg) Bathtub Urinal Lavatory (Wash Basin) Drinking Fountain Shower Floor Drain Kitchen Sink & Disposal Grease Trap Dishwasher Roof Drains Clothes Washer Medical Gas Water Heater Other: Sink (Service/Bar/Mop/etc.) Other: ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comp/y 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 pertorm the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. �� nature I �2�-�;�� Date City of Everett Official Use Only PERMIT# / `\� � lJ (Revised 10/12/2015 � / 1� �.%% ��/ �1 F/ I � �