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� t�uiidmg #y�z � <br /> PERMIT APPLICATION <br /> BUILDING /MECHANICAL 1 PLUMBING/SiGN/ =1NKLER 1 DEMOLITION <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET,EVERETT,iNA 98209 <br /> {P)425-257-8810 � FAX 425-257-8857 �(E}everetteps�everettwa.gov� www.everet#wa.gov/permits <br /> (Blue or Bfack Ink�nly Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS. 900 W Casino RD, Everett, WA 98204 PROPeim zax#: 00392100000401 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. {attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Trailside Preservation LP TENANT NAME{If Commercial): <br /> OWNER MAIUNG ADDRESS: S,�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,TM Torrance STA7E WA Z� 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick Preserva#ion artners.or <br /> coNr�u►cTOR�,4rNe: Holmberg Company <br /> CONTRACTOR ADDRESS: sr+�Eer 1128 8th st <br /> ��„- Kirkland STATE WA Z�P 98033 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUtRED): HOLMBC*066ME CITY OF EVEi2ETT BUSINESS LICENSE#(REQUIRED): OFJ1 003 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER{Please Specity) <br /> CONTACT NAME: Jacob Klein CONTACT PHONE: L�ZS-C7O2-7370 <br /> CONTACT EMAIL: ,lacobK�a holmber co.com <br /> BUILDING PERMIT APPLICATION <br /> Existin Use of Build'+n : Contract Price of Wark:S 1400 <br /> Pro sed Use of Buildin : Heat Source: OGas DElectric ❑Other <br /> Buildin T : �SFR-Detached ❑SFR-Attached ❑Du lex OMulti-Famil of Units: ❑Commercial ❑Industrial <br /> T e of Pro'ect: �New DAddikion ORemodel ❑Re air OT.I. ❑Si n ❑S rinkler ❑Demalition ❑Chan e of Use <br /> DESCRIPTION OF WORK: yL��� ���„� �+�L�.,�.R� ��,4� ��qdS. � �'�'"`�°� <br /> Gh�'�P�j. v <br /> ASSOCIATED BUfLDING PERMIT# if a licable : <br /> MECHANICAL PERMIT APPLICATION PLUMBiNG PERMIT APPLICATION <br /> Type of Project: _New Addn X Alteration _Repair Type of Project: _New Addn AlteraHon _Repair <br /> #of �Fst of Fixtures #of �st of�xtu►+es #of �st of Fixtures �°f List of Fixtures <br /> Ffictures Ffxtares Fixtures Flxtur+es <br /> A1C—Air Handli Units Heat Pump Toilet Backflow Preventer(Inside Bld <br /> Forced A'rr S tems Unit Heater Bathtub Urinal <br /> Gas Pi in Boiler Lavato ash Basin Drinkln Fountain <br /> Water Heater Refri eration Shower F1oar Drain <br /> Gas Fire lace Wood Stove Kitchen Sink 8�Dis sat 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 Fen Sink(ServiceJBar/Mo etc. Other: <br /> SPRINKLER!SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKN04VLEDGEMENT:1 have reviewed thls application and confirm the informatlon contelned hereJn Is Uve and coned.Work done pursuant to this parmit must comp/y with <br /> carrent federal,state,ana tocar rsw.The grenting of e permit only authorizes approved work and no deviaGons therefiam.DevfaHa�s must ffrst be authorized in writing fmm the <br /> Building OflScia!before being aulhorized under any circumstance.f am the owner,or!am authorized by ihe ourner of this property to perform the work for whlch application is made, <br /> and I comply with the State Contiacto�s taw i8.27 RCW and 296.200A W/IC. <br /> Ciry of Everett Ofl'iciel Use Only <br /> � ��� /'�� PERMIT# 'O <br /> � ���, <br /> Owner/Authorized As�ent Sipna#ure Date fRevised 9I2312096) <br />