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� �u�ia�ng �yz4 � <br /> PERMIT APPLICATIOt� <br /> BUILDING/MECHAWICAL/PLUMBING i S1GN ��INKLER�DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> {P)425-257-8810 � FAX 425-257-8857 �{E}everetteps@everettwa.gov� vuww.everettwa.gov/permits <br /> (Blue or Blacklnk Only Piease) PROJECT SITE iNfORMATION <br /> PROJECT SITE ADDRESS: 9OO W CaSIf10 RD, Everett, WA 98204 PROPERTY TAX#: 00392100000401 <br /> LEGAL for new consfruction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> COUITACT INPORMATION <br /> OVYNER NAME: Traiiside Preservation LP TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: S,�E� 21515 Hawthorne BLVD. Suite 390 <br /> Cm Torrance STA,� WA Z�P 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAII.: Nick Preservation artners.or <br /> coNTw►croR NauiE: Holmberg Company <br /> CON7'RACTOR ADDRESS: STREET 1128 8th s# <br /> �m Kirkland STA� WA Z� 98033 <br /> CONTRACTOR PHONE: GONTRACTOR EMAIL: <br /> CONTRACTOR UCENSE#(REQUIREDj: HOLMBC*066ME CITY OF EVERETi`BUSINESS LIGENSE#(REQUIRED): OrJ�I 003 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR �OTHER{Please Speciy) <br /> CONTACT NAME: JaCO�J KI6111 CONTACT PHONE: t�25-�`jQ2-737� <br /> CONTACT EMAIL: JaCOI�K�f10I�'YIIJBf CO.com <br /> BUILDING PERMIT APPLICATION <br /> ExisGn Use of Buildin : Contract Price of WoHc:S 1400 <br /> Pro sed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T : ❑SFR-Detached ❑SFR-Attached ❑Du lex �Multi-Famii -#of Units: ❑Commercial ❑Industrial <br /> T e of Pro'ect: ❑New �Addition ORemodel ❑Re air �T.I. ❑Si n ❑S rinkler ❑Demolitlon �Chan e of Use <br /> DESCRIP710N OF WORK: yL���� �orn �.'�S,�.R,� �„4� ��d�, � ��'•a� <br /> G�•�.��, �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 _Addn _Alteratton _Repai� <br /> #of #of �l of #of <br /> Fixttires LFst of Fxtures Fr��� tist of�xtures ��u�s tist of�xtures F��s List of�xtures <br /> AlC–Air Handlin Units HeafPump Toilet Bacfcflow Preventer Inside Bld <br /> Forced Air S tems llnit Heater Bathtub Urinal <br /> Gas Pi in Boiler l.avato Wash Basin Drinkin Fountain <br /> Water Heater Refi eration Shower Floor Drain <br /> Gas Fireplace Waod 8tove Kitchen Sink 8�Dis osal Grease Tra <br /> Gas Range 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(ServicelBar/Mo /etc. Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT.•!have reviewed thls applfceUon and confirm the infom�ation confafned herain Is We and correct.Work done pursuant to ihis permif must comply wlth <br /> cument federal,state,and/oca!law.The grenting of a permit only authorizes�pproved work and no deviations therefrom.Deviatlons must Brst 6e authorrzed in wrilrng fmm ihe <br /> Building OhSciat before being euthodzed under any circumstance.l am the o►amer,or 1 am authorized by the owner of thls property to perlom+the work for whJch application is made, <br /> and J comply with the State Contractors Law l8.27 RCW and 296.200A WAC. <br /> City of Everett O/ficia!Use Only <br /> t � ���� PERMIT# �� — <br /> ��� �� , 3 a <br /> OwnerlAuthorized Aaent Sipnature �ate (Revlsed 9J23/2016) <br />