Laserfiche WebLink
� r�u�ia�ng #yz� � <br /> PERMIT APPLICATION <br /> BUILDING /MECHANICAL 1 PLUMBING /SIGN I II�INKLER/ DEMOLITION <br /> CITY OF EVERETT PERM�T 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 /> (Blue or Blac�c lnk Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 900 W Casino RD, Everett, WA 98204 PROPERTY TAX#: 003J2�O000040� <br /> LEGAL for new construction: Sfiort PlaVsubdivision Lot No. {attach copy of long legal description) <br /> CONTACT INFORMATION <br /> 01AMER NAME: TI'aIISICIB PC@S@I'VS�IOtI LP TENANT NAME{If Commercial): <br /> OWNER MAI�ING ADDRESS; S,�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,TM Torrance STATE WA Z� 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick Preservation artners.or <br /> coNTw►croR HaHe: Holmberg Company <br /> CONTRACTOR ADDRESS: STREET 1128 8th st <br /> �m Kirkland STA7E WA =�P 98033 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#{REQUIREDj: HOLMBC*066ME CITY OF EVERETT BUSINESS LICENSE#{REQUIRED�: OS1 003 <br /> PRIMARY CON7ACT: ❑OWNER �CONTFiACTQR �OTHER(Please Specify) <br /> Ct�N7ACT NAME: J�COI� KI@It1 CONTACT PHONE: t}2�j-�O�_]37Q <br /> CONTACT EMAIL: �acobK ar holmber co.com <br /> BUlLDING PERMIT APPLICATION <br /> Existin Use of Buildin : Contract P�ice of Work:E 1400 <br /> Pro sed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T : ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T of Pro'ect: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: �,G���� ��� `p,x��,�,� �M 4� �� t�, � ��'Q� <br /> Gh�..��5, �� � <br /> ASSOCIATED BUII.DIMG PERMIT# if a licable : <br /> MECHANICAL PERMIT APPLICATION PI.UMBING PERMIT APPLICATION <br /> Type of Project: _New Addn X Alteration _Repair Type of Project: New _Addn _Alteratlon _Repair <br /> #of Lfst ofi�xtures #of �st of�xtures �of List of�xtures �of Llst of Fiutures <br /> Fixtures Ffxfures Fixtures Flxtures <br /> A/C—Air Handli Units Heat Pump Toilet Backflow Preventer{Inside Bld <br /> Foresd Air S tems Unit Heater Bathtub Urinal <br /> Gas Pi in Boiler Lavato ash Basin Drinking Fountain <br /> Water Heaier Refi eration Shower Floor Drain <br /> Gas Fire lace Wood Stove Kitchen Sink&Dis osal Grease Tra <br /> Gas Rar� e Ducting Dishwasher Roof Drains <br /> Clothes D er Hooku s Other. Clothes Washer Medical Gas <br /> Ran e Haod Water Heater Uther: <br /> Exhaust Fan Sink Service/Bar/Mo letc. Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKN04V1.EDGEMENT.1 have reviewed thls applfcation and con�irm the informaUon contelned herein!s true and wrrect.Work done pursuant to this perm8 musf comply wlth <br /> cument federaf,sfate,and locel law.The granting of a permit only authorizes approved work and no deviations therefrom.DeviaHons must frrst be authorized fn wrrting from the <br /> Building Official before being authorized under any circumstance./am the owner,or I em authorized by the owner of thfs property to perform the work for whlch applicaUon is made, <br /> and 1 comply►yith the Siafe Contractors Law 18.27 RCW and 296.200A WAC. <br /> Cfty of Everett Official Use Only <br /> <'�/ri�G, � ��/� � PERMI` `� �.\�� � O <br /> OwnerlAutMorized Aaent Sipnature Date lRevised 9123/201fi) <br />