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PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />���, <br />� 04 a� �r ink Only Po se .. , P:,Ii;L1 ECT SITJE' w ATfDN a' y , <br />PROJECT SITE ADDRESS: 10115 Holly Drive, Everett, WA 98204 PROPERTY TAX #: 28042400201100 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />,a. :.« .'' COM!N7`AC�' INFORMATIQsI k 7 <br />OWNER NAME: STANDARD JSP OLIN LLC TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 655 MONTGOMERY ST STE 1700 <br />cITY SAN FRANCISCO STATE CA zip 94111 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): SL Jy g 0 CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): t <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR P OTHER (Please Specify) Architect <br />CONTACT NAME: <br />MATT SCHREIFELS <br />CONTACT PHONE: 425-252-2153 <br />CONTACT EMAIL: mattS 2812architecture.com <br />£: <br />r h BUID�NGPERN#TAPLIGI►'1�ON <br />y. <br />Existing Use of Building: Multiple FamilV Apartments <br />Contract Price of Work: $ 3 oD O O <br />Proposed Use of Building: NO Change <br />lHeat Source: QIGas OElectric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached []Duplex 2Muiti-Family-# of Units:_ Wommercial ❑Industrial <br />Type of Project: El New ❑Addition []Remodel ORepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />Repair/restoration of Building N, unit #'s N102, N202 & N302 to prefire condition. Defered/seperate permits if required for Electrical, Mehanica Plumbing <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />K NIECHANICAL�PERMIT ,A�PPICATION , ,; <br />� • ;. `; �,� F , PLUIVIB�NG PERMI�AP�P sr CATION• �' � �s�, , , ; <br />Type of Project: _New _ Addn _Alteration Repair <br />Type of Project: _New _Addn AAlteration Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixturesl <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fix res <br />List of Fixtures <br />A/C — Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />od Stove <br />Kitchen Sink & D posal <br />G ase Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />oof Drains <br />Clothes Dryer oku <br />Other: <br />Clothes W Sher <br />Medical Gas <br />Range Hood <br />Water ater, <br />Other: <br />Exhaust F <br />Sin Service/B r/ o e <br />Other: <br />SPRIN <br />„ LR W/ SI�PRESSONt�YST1 <br />�Vl; <br />Chemical or Water <br />I <br />No. 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 1 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 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />Agent Signature <br />r 3!— <br />Date <br />PERMIT # <br />rl�, fb I s® <br />(Revised 9/23/20 <br />