915 RUCKER AVE 2017-01-13 - Laserfiche WebLink

� � � PERMIT APPLICATI BUILDI�/ MECHANICAL / PLUMBING / SIG 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 � www.everettwa.gov/permits PROJECT SITE INFORMATION rRVJCV 1 J11 C HUURCJJ: /,j I(,� ��ICGf� /,}� 1/ I� II"KVI"CK I T 1 HA if: /\O/.�„� �^ �^ � oO r^� .�4 V V�L. � 1 � 1� lJ -�'.j G � Y/ LEG/�!L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) OWNER NAME: JAY 1 D OWNER MAILING ADDRESS: CONTACT INFORMATION S TENANT NAME (If Commerc STREET ��n OWNER PHONE: ZO�O. �-f�j . CONTRACTOR NAME; �ZOD►�JE`+ CONTRACTOR ADDRESS: srREET CITY CONTRACTOR PHONE: �-i2S . , CONTRACTOR LICENSE #(REQUIRED) PRIMARY CONTACT: ❑ OWNER CONTACT NAME: / l �%�i'f-�EJI� �T�(ff� /f� �1,5 12uLY-�- A�V E i�V C�� 1 � STATE yV () � C'CI O OWNER EMAIL: J A.�U S 5� C L.�uN T�t N EN �'�71A t�l T I� 4 b�Sl L �4200 � t�`�- �PrvE- Y�I ��`��DS . STATE WR Z�P �l � Zc� J m a 1 l� Co n� 1. � � CONTRACTOR EMAIL: I 1�� I %LP�1�f�' )�� I 6� CITY OF EVERETT BUSINESS LICENSE CONTRACTOR � OTHER (Please Specify) CONTACTPHONE: �� Z�Cj, �/00 CONTACT EMAIL: �� fa�� G BUILDING PERMIT APPLICATION ZIP � S O (�t0 . EQUIRED : ' �`�'� PT :t� 1 Z3i��1 �f �S'• 77 / . lv�.S�7 J �S'/9!�! • C oyy� Existing Use of Building: Contract Price of Work: $ 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: / ��! f�{-T1�v�l f��1L I ff"� %1��7� ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Fixtures List of Fixtuies Fixtures List of Fixtures A/C — Air Handling Units Heat Pump Forced Air Systems Unit Heater Gas Piping Boiler Water Heater Refrigeration Gas Fireplace Wood Stove Gas Range Ducting Clothes Dryer Hookups Other: Range Hood Exhaust Fan PLUMBING PERMIT APPLICATION Type of Project: _New _Addn _Alteration _Repair # of List of Fixtures # of List of Fixtures Fixtures Fixtures 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: Q Lij � ME SPRINKLER / SUPPRESSION SYSTEM Number 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 granfing of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the Building O(ficial 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 PERMI,T # 32�� i�o3 - c�l� Owner/ uthorized Agent Signature Date (Revised 10/12/2015)