1205 RUCKER AVE 2019-07-08 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/ PLUMBING /SIGN /SPRINKLER/DEMOLITION ,-1 CITY OF EVERETT PERMIT SERVICES sjM 3200 CEDAR STREET,EVERETT,WA 98201 ORIGrr tN/� (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov www. a.gov p A fI i_ M o , r JCSITErINFORMAION `: _ll �i ti - 1, nj PROJECT SITE ADDRESS: VIA 5.-1' „,_ , flw PROPERTY TAX#:8),\Q(1 V 1//)1 O 1M ii/1� LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) „ „ ,t _ 'CONT ICN+INFO MATION �� r, sL_tu a Vl;. OWNER NAME: ,Virl/13)L\ .3(i lIVan TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREETJ'/U� F�)&h(/ 141./..e ///`/�J cityVire-R.VVSTATE �� ZIP /97a I OWNER PHONE: 41 ' 112-- G OWNER EMAIL: — 666 V CONTRACTOR NAME: -15)1/P nant3(i) CONTRACTOR ADDRESS: STREET 111 Cj Z�,Q�*1 (S" # I CITY WD( 144 �Wl,w(1�� STATE'kVA-- Apr,r CONTRACTOR PHONE:Ll 711 _l,34 ••• 111 'CONTRACTOR EMAIL: I�D mti (rim �D�J CONTRACTOR LICENSE#(REQUIRED):VWEFF '�' i f /ta CITY OF EVERETT BUSINESS LICEN�REQUIRED): Z /L7 . PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) y CONbiiit'i TACT NAME: /� . CONTACT PHONE: L �-71 ... 7 )30 k( i .e CONTACT EMAIL:I 7f(4l/}104Grain p' " / -. (Wm ,u �� L '-. ."' - , '-�U LDING 0.7**Mi APPLICA`tioi�- J�V,r� " _ K m Existing Use of Building: Contract Price of Work:$.:Is Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: —R-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New Addition ❑Remodel ❑Repair ❑T.I. Cl Sign CI Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: A /c . ii is ASSOCIATED BUILDING PERMIT#(if applicable): .'s MECHANICAL''PERMIT APPL'ICATION..i" a,',. `' ;'!,PLUMBINGIPERMIT APPLICATION a7 4,,,4A Type of Project: _New (Addn _Alteration _Repair Type of Project: _New _Addn Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures ' A/C–Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) 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;I SUP,PRES„SIOIfSYSTEM,a'. ,„ 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 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 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 b a PERf,�Y(T�# !1 oq I O i: / ••)+FXT ASigna Lire at (Revised 10/12/2015)