4417 RUCKER AVE 2017-01-13 - Laserfiche WebLink

P IT-�tPPL-l�ATlO BUILDIN�IIECHANICA , UMBING IG RINKLER / DEMQLITION 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 PROJECT SITE ADDRESS: � y� / ROPERTY TAX #: l LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: �%��,�G �J '�, •e��.� TENANT NAME (If Commerciai): OWNER MAILING ADDRESS: sTHee CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME; CONTRACTOR ADDRESS: srrzEer CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION 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 ❑Remodei ❑Repair ❑T.I. ❑5ign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: �;� ��1 �vl,�; i� �� Fi ��M� -� ��f7� l n� I� �r�� L �--J R � I �,� � ASSOCIATED QUILDING �ERMIT #(if applicable): � l � MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APP TION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn Altera ' a� _Repair # of Lisf of Fixtures # of List of Fixtures # of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixfures Fixtures A/C — Air Handling Units Heat Pump Toilet Backflow Preventer (Inside Bidg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory (Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink & Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: SPRINKLER / SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT: I have reviewed this application and confirm the infonnation contained herein is true and co��ect. Work done pursuant to this permit must comply with currenf federal, state, and local law. The g�anfing 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 1 am authorized by the owner of this property to perform fhe work for which application is made, and l comply with the State Contractors Law 18.27 RCW and 296_200A WAC. Z-2� r/Authorized �gent Signature 1> � L�� Date Ll n l�X City of Everett O(ficial Use Only PERMIT # � � l � , ( �� �� IC�_, � (Revised 10/12/2015) A,Z T %�% 7/