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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 />OOL (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 1304 10 0 TH PL . S.E. <br />PROPERTY TAX #: 280519 0 01017 00 <br />LEGAL for new construction: Short Plat/subdivision See attached Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Rowland Heights Pres. c/o Julia Arisiaga TENANT NAME (If Commercial): Trail side Village Apts . <br />OWNER MAILING ADDRESS: STREET 21515 Hawthorne Blvd. , Suite 390 <br />CITY Torrance STATE CA zip 90503 <br />OWNER PHONE: (310) 8 0 2- 6 6 7 6 <br />OWNER EMAIL: <br />CONTRACTOR NAME: Mike Grier - Tersuli Construction Services <br />CONTRACTOR ADDRESS: STREET2633 Eastlake Ave. E., Suite 202 <br />CITY Seattle STATE WA zip 98102 <br />CONTRACTOR PHONE: 2 0 6- 5 3 5- 8 4 8 5 <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): TERSUCS 8 91DW <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 0 51 16 5 <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR MOTHER (Please Specify) -Owner Is Agent <br />CONTACT NAME: Chris Bacus <br />Pacific Engineering Tech. <br />CONTACT PHONE: 2 0 6- 2 81- 7 5 0 0 <br />CONTACTEMAIL: cbacus@pacengtech.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Apartments (Multi - f ami 1 y) <br />lContract Price of Work: $ 3 5, 0 00 <br />Proposed Use of Building: No Change <br />Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ®Multi -Family-# of Units: 250 ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ®Repair ❑T.I. ❑Sign []Sprinkler ❑Demolition ❑Chan e of Use <br />DESCRIPTION OF WORK: Fire damage repair to an existing apartment building <br />U� 01-10 lZ <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: New _ Addn _Alteration Repair <br />Type of Project: New Addn _Alteration Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <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 />Wood Stove <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />Water Heater <br />Other: <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Number of Heads <br />ACKNOWLEDGEMENT: / 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. / am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />641, 3/31/16 <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT # ^� I� )/�) <br />IJVV <br />(Revised 10/12/2015) <br />