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3020 RUCKER AVE SNO CO HEALTH DISTRICT 2018-01-01 MF Import
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3020 RUCKER AVE SNO CO HEALTH DISTRICT 2018-01-01 MF Import
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Last modified
8/6/2019 12:14:36 PM
Creation date
3/8/2017 10:37:55 PM
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Address Document
Street Name
RUCKER AVE
Street Number
3020
Tenant Name
SNO CO HEALTH DISTRICT
Imported From Microfiche
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'"�1r' , <br /> , APPLICATIbN FOR CON�TRUCtION PERMIT <br /> everett <br /> Ihe Erergreen <br /> CITV OF � <br /> everett <br /> ! BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK—PLEASE PRINT � <br /> � ❑ DEMOLITION CI COI.IBINATION ❑ BUILDING I IMECHANICAL [�I'PLUMBING ❑ SIGN <br /> OMMER MRILADDRESS CITY 21P PNONE <br /> � �.u�..�T � a4sSoc�a7.�s . 3oZ� Q,�c(c�,a/t Sc+r7c+- 30 � C�f,�.e�,�-�, 25�-24�Z <br /> TEN�NT M�ILAO�RE55 CITY--T 21P P ONE � <br /> �aciFic NoQ7'I-Iwws? /�S `rcN�caGrcae2 Sc12c���es . 3U2o�2,,�ckw./�.5�.��+- 3os"'- tr+/t+Crr-7,r' <br /> ��. ARCHRECTOROESIONER MAILADDRE55 CITV ZIP � PMONE <br /> ' GENER�LCONTR�CfOR M�ILADDRESS CITV IIP PHONE LIGENSE� <br /> MECH�VlIC�L CONTR�::TOR M41L AODPESS CITY i1P PMONE UCEHSE 1 <br /> ' PWMBINOCONTRACTDII M�IL�DOPE55 dTY 2m PMONE UCENSEI <br /> � CLASSOFWORK <br /> � ❑ NEW f�DDITION ❑ ALTERATION ❑ REPAIR I.1 DEMOLITION LI WOODSTOV6FRPL INSERT ❑ BUILDING RELOCATION <br /> , TENANTMPROVEMFNTORINTERIORREMODELONLV CONTACTPERSONRNDPIIONENO. <br /> CONTPAGT PNICE OF WORN: <br /> . DESGRIBE WORk�ND SOU�RE FOOTAGE INVOLVED <br /> : PPOPOSE�USEOFBUILDINO I HEREBV CERT�FV THAT I HAVE READ AND EXAMINED THIS <br /> p � � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEO�LDESCPIPTqNOFPROPENTV�SNOWNPELOWOR�TT�CHFWRCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNIN.]THISTYPEOF <br /> WORK WILL BE COMPLETED WiTH WHETHER SPECIFIED HEREIN OR <br /> �or eiocK _ ov NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOHITV TO VIOLATE OR CANCEI THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION,THAT I AM AUTHORIZED BY THE <br /> � OWNER O�� THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � WNTRAC?ORS LAW 18.27 flCW AND 296200 WAC. <br /> , SIGN�TOAEOI°CONTRRCLORORAUTNONIZEDAGENT D�TE <br /> � PROJECTADORE55 ^�"� � ��Z I S_S� <br /> O U � APPLICANiSdTVBUSM ENSEIp.AN SINES 4MIE � <br /> / N <br /> � PLUMBINO MECHANICAL � <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) NC—NHNDLG UNITS—H.P. � <br /> � BATHTUB FORCEDAIRSYSTEMS—B.T.U. M E.A. <br /> UVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> ' SHOWER ' CLOTHES DRVERS � <br /> ' KITCHEN SINK 8 DISP i VENTILATION FAN ; <br /> . DISHWASHER RAN�E HOOD <br /> IAUNDRYTRAY WATF.R HEATER � � <br /> � CLOTHES WASHER WOOD STOVE � <br /> URINAL ' METAL FIREPIACE 8 CHIMNEY � <br /> � DRINKING FOUNTAIN i FlFEPLACE INSERT ; <br /> � FLOOR DRAIN � HEA7 PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> . ROOF DRAINS—fiAINLEADERS � E%HAUST FAN T— <br /> � SINK(SERVICE—BAR,ETC.) ; ' <br /> . � <br /> . � � <br /> � -- — � <br /> � � <br /> � � <br /> - � SUBTOTAL $ SUBTOTAL S ' <br /> PERMIT $ � PERMIT $ � <br /> TOTALFEE $ TOTALFEE $ � <br /> � FRONTSETBIICK RE�PSETBACH SIOESETBACK PIANCNECNNUMBER FEE flECEIPTNO. <br /> 1 USE20NE LOT�REA VRCANTSITE FEF.S VAIUATION FEE <br /> ' ❑ YES �] NO gUILDING i <br /> 7VPEOFGOHSTALLOW�BLE IYPEOICONSI.ACiUAL aCureMr rmq6MUMcuxnS . <br /> GNWC � <br /> ' PLUMBING ' <br /> � � <br /> � SIZEOFBlDO. NO.OFSTOBIES BASEMENT MECHANICAL � <br /> � I7 YES Cl NO <br /> , OCCUPANCY1011D FIPESPRNNLERSREO'D NEIGHiLIMITATION OTHER i <br /> i I�1 VES I I NO STATE BUILDING SUflCHAfiGE � <br /> I RE�SONFORSPflINKLEflS —� <br /> � STAiE ENEfiGV SURCHARGE i <br /> i <br /> � APPLIC�TIONACf,.BY FLANS APPROVEDOV CITY OF EVERETT PUBLIC WORKS � <br /> i LOCAL SALES � <br /> � TA)(CODE IS 3705 TOTAL � <br /> � <br /> ! <br /> s <br /> ?.�•ria►�cr,:c-.e :. .._ . .. . . � .: . . . , i. '. <br />
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