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� �u�ia�ng �yos � <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SiGN / =1NKLER 1 DEMOLITION <br /> CITY OF EVEi2ETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 9$201 <br /> (P)425-257-8810 � fAX 425-257-8857 �{E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> (Biue or Black Ink�nly Piease) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 9OO W CaSitlO RD, Everett, WA 9$2OA� PROPERTY TAX#: 003921000004�1 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TCc'�IISICI@ PCeS@tVc'�#IOtI LP TENANT NAME(If Cnmmerclal): <br /> OWNER MAILING ADDRESS: S�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,� Torrance STA,� WA Z� 90503 <br /> OWNER PHONE: 31 Q-802-6652 OWNER EMAIL: Nick Preservatian artners.or <br /> coNTRncroR r,an�e: Hoimberg Company <br /> CONTRACTOR ADDRESS: srneer 1128 8th st <br /> �m Kirkland STA� WA Z�P 98033 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR UCENSE#{REQUIREDj: HOLMBC*066ME CITY OF EVEREIT BUSINESS LICENSE#(REQUIRED): OtJ�003 <br /> PRIMARY CON7ACT: ❑OWNER �CONTRAGTOR ❑OTHER{Please Specify) <br /> CONTACT NAME: Jacob Klein CONTACT PHONE: 4Z�J-�OZ-737O <br /> CONTACT EMAIL: JaCOI�K�hOIt11IJ@I' co.com <br /> BUlLDING PERMIT APPLICATIQN <br /> Existin Use of Buiidin : Contract Prlce of Work:S 1400 <br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑Electric �Other <br /> Buildin T : �SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famii -#of Units: OCommercial ❑Industrial <br /> T e of Pro'ect: ONew ❑Addition ❑Remodel ❑Re air ❑T.i. ❑Si n OS rinkler ❑Demolition �Chan e of Use <br /> DESCRIPTION OF WORK: yL�,P`� �orn p�ti[�,�.�,� �„4� ��d�, � ��'o�' <br /> �h�.`��, �J v <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: New Addn X Alteration _Repair Type of Project: _New Adtln _Altaration _Repair <br /> #of tist of Fixtures #°f List of�xtures #°f Liat of Fixtures #of List of Ffxtures <br /> Fixtures Fixtures Fintures Fixtures <br /> A!C—Air Handlin Units Heat Pump Toilet Backflow Preventer{Inside Bid <br /> Forced Air S tems Unit Heater Bathtub lirinal <br /> Gas Pi in Boiler Lavato ash Basin Drinkin Fountain <br /> Water Heater Refi eration Shower Floor Drain <br /> Gas Fire lace Wood Stove Kitchen Sink 8�Dis osal Grease Tra <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes D er Hooku s Other. Clothes Washer Medicai Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink{Service/BarlMo /etc. Other: <br /> SPRINKLER/SUPPRE3SlON SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT.•1 have reviewed thls applfcation and confirm the information contained herein!s We and conect.Wak done pursuant to this permit must comply with <br /> cuirent/ederaf,state,and loca!law.The grenting of e pennit only authorizes approved work and no deviations therefrom.Deviatlans must first be authorized in wrrting fmm ihe <br /> Building Off'icial before being authorized under any clrcumstance.1 am the owner,or 1 am authorized by the owner of thls property to perform the wo�k for which application is made, <br /> and!comply wRh ihe State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Officia!Use�nly <br /> � � /���� PERMIT# �� � O�S <br /> ��\ <br /> Owner uthorized Aste t Sipnature Date {Revised 9J23I2t31S) <br />