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PERMIT APPLICATIOISPRINKLER <br /> BUILDINGOIECHANICAL / PLUMBING / SIGN / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OE;L 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 4208 Rucker Avenue PROPERTY TAX#: 00582202300801 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Dean & Chris Amante TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 33456 <br /> CITY Seattle STATE VV1nI <br /> a ZIP 98133 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAM tt <br /> CONTRACTOR ADD ESS STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: - (p ---� S ZCONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): %ktl In /-�--N '- f CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): , Q <br /> PRIMARY CONTACT: DOWNER 11 CONTRACTOR 6 OTHER(Please Specify) <br /> AUTHORIZED AGENT <br /> CONTACT NAME: CONTACT PHONE: (206)522-3830 <br /> Brian J. Harris/TCA Architecture Planning CONTACT EMAIL: brian@tca-inc.com <br /> BUILDING PERMIT APPLICATION d <br /> g g 3,645 SF Contract Price of Work: $ n <br /> Existing Use of Building: <br /> Proposed Use of Building: Heat Source: qGas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: WCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition IXRemodel E]Repair qT.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> INTERIOR TENANT IMPROVEMENTS & MINOR EXTERIOR ELEVATION REMODEL <br /> -BH+L-91 . SEE NOTE 1 ON SITE PLAN FOR ADDITIONAL DESCRIPTION. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of #of #of #of <br /> Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures List of Fixtures <br /> Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18 27 ROW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> P E TT OC;i� <br /> Owner/Authorized Agent Signature Date (Revised 5/20/2016) <br />