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PERMIT APPLICATION <br /> 4/101 111111r_. BUILDINaECHANICAL/PLUMBING /SIGN' =RINKLER I DEMOLITION <br /> /��1•'�'•'' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3105 Pine Street PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Hollander Investments, Inc. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 119 N. Commercial Street, Suite 165 <br /> c,TY Bellingham STATE WA Z,P 98225 <br /> OWNER PHONE: (360)647-1916 OWNER EMAIL: barb@hollanderinvestments.com <br /> CONTRACTOR NAME: Hollander Investments, Inc. <br /> CONTRACTOR ADDRESS: STREET Same as above <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: (360)202-1255 CONTRACTOR EMAIL: serj@hollanderinvestments.co.. <br /> CONTRACTOR LICENSE#(REQUIRED). CITY OF EVERETT BUSINESS LICENSE#(REQUIR=O). <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR %OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (206)341-9875 <br /> David Murphy CONTACT EMAIL: dmurphy@murphyvarey.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Hotel Contract Price of Work:$ <br /> Proposed Use of Building: Hotel Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition jgRemodel ❑Repair ❑T.I. DI Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ■ U - : • • : ` = _ • • •• •• •f a - - ' • , • e <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 List of Fixtures #of List of Fixtures #°f List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures 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 /> 1 - 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 /> Chemical or Water No.of Heads <br /> 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 <br /> current federal, -,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 Offici. .- .r-being authorized nder 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 i, 1- :to Contracto s Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> / PR IT <br /> 12/11/17 12- 105b <br /> Owner/A orized Agent Signature Date (Revised 9/23/2016) <br />