Laserfiche WebLink
� �u�iamg �yo4 � <br /> PERMIT APPLICATION <br /> BUILDING /MECHANICAL/PLUMBING /SlGN / lINKLER/ DEMOLlTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-$810 � FAX d25-257-885i �(E}everetteps@everettwa.gov� www.everettwa.gov/permits <br /> (Blue or Black Ink Oniy lease) PRCJECT SITE INFORMATION <br /> PROJECT SITE ADDRES � Casino RD, Everett, WJfl1 98204 PROPERTY TAX#: 0O:39Z�O000040� <br /> LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: reservation LP TENANT NAME(if Commercial): <br /> OWNER MAIIING ADORESS: S�E� 2159 5 Hawthorne BLVD. Suite 390 <br /> C,� Torrance STA'tE WA z� 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick Preservation artners.or <br /> coNTRncroR NnMe: Holmberg Company <br /> CONTRACTOR ADDRESS: srne� 112$ 8th st <br /> �m Kirkland STA� WA =�P 98033 <br /> CONTRACTOR PWONE: CONTRACTOR EMAIL: <br /> CONTRAGTOR LICENSE#{REQUIRED): HOLMBC*O66ME CITYAF EVERETi BUSINESS UCENSE#(REQUIRED): OrJ�OOS <br /> PRIMARY CON7ACT: ❑OWNER �CONTFIAGTC3R ❑OTHER(Please Specify) <br /> CONTAGT NAME: Jacob Klein can�Tacr P�oN�: 425-602-7370 <br /> CONTACT EMAIL: JaCOI�K@F10It11I?@C CO.com <br /> BUILOING PERMIT APPLICATION <br /> ExisGn Use of Buildin : Contract Price of Wark:S 1400 <br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑Electric �Other <br /> Suildin T e: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T e of Pro'ect: ONew ❑Addition ❑Remodel �Re ai� ❑T.1. [7Si n ❑S rinkler ODernolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: �G�p�� �o�„� �1��,�.�� �„�� �� l�, � ��'Q�— <br /> Gr•�.►��, � <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn X Alteration _Repair Typa of Project: New _Addn _Altaration _Repair <br /> #of tfst of Ffxtures #°f LFst of Fixturps #of tist of Fixh►res #of List of Fixtures <br /> Fbclures Fbcfnres Fixtures Fixtures <br /> A/C—Ai�Handlin Units Heat Pump 7oilet Bacicfiow Preventer(Inside Bid <br /> Forced Air S tems Unit Heafer Bathtub Urinai <br /> Gas Pi in Boiier �avato ash Basin Drinking Fountain <br /> Water Heater Refri eration Shower Floor Drain <br /> Gas Fire lace Wood Stove Kitchen Sink 8�Dis osai Grease Tra <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes D er Hooku s Other. Clothes Washer Medical Gas <br /> Ran e Hood Water Heater Other: <br /> Exhaust Fan Sink(ServiceBar/Mo letc. Other: <br /> SPRINKLER!SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed thJs applfcatian end con�irm the informaUon contelned he�ein is tn►e and conect Work done pursuent to this permit must comply with <br /> cument federal,state,and loca!law. The grenting oia permit only authorizes approved woMc snd no deviations therefrom.Deviations musi frrsl6e authodzed in writing fron�ihe <br /> Building OflScial before being authorized under any circumsiance.i am ihe owner,or!am authorized 6y the ownsr of thls properfy ta perform the work for which application is made, <br /> and!comply with the State Coniractors Law 18.27 RCW and 296.200A WAC. <br /> City of Evereit Official Use Only <br /> ���/�� PER IT# � �^ <br /> � � C <br /> Owner/Authorize As�ent Sipnature Date (Revised 9123/2016) <br />