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� �unamg �y;�z � <br /> PERMIT APPLICATION <br /> BUILDING I MECHANtCAL i PLUMBING !SIGN/ I�INKLER!DEMflLITIC�N <br /> CI7Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 ({E)everetteps@everettwa.gov� www.everettwa.govipermits <br /> {B{ue or Black Ink Only Pleas+e) PROJECT SITE INFORMATION <br /> n�a�Ec�r sir�,e►ou�ss: 900 W Casino RD, Everett, VIIA�8ZO4 PROPERTY i'AX#: �003921004U0401 <br /> LEGAL for new construction: Short PlaVsubdivision Lot No. {attach copy of long legal description) <br /> CONTACT INFORMATIGN <br /> OWNER NAME: TI'aIISICIG Pt'@SeNa#IOtI LP TENANT NAME(ff Commeraial): <br /> OWNER MAILING ADDRESS: S,�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,� Torrance STATE WA Z� 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick Preservation artners.or <br /> coNrw►croR NaaE: Holmberg Company <br /> CONTRACTOR ADDRESS: srn�T 1128 8th st <br /> �� Kirkland STA,� WA =� 98033 <br /> CONTRACTOR PHONE: CONTRACIOR EMAIL: <br /> CON7RACTOR LfCENSE#(REQUIRED): HOLMBC*OC�ME CITY OF EVEREIT BUSINESS LICEMSE#(REQUIRED}: O�J1 003 <br /> PRIMARY CC3NTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CaNTACT NAME: CONTACT PHONE: �ZrJ-�O�-7:��0 <br /> Jacab Klein <br /> caNTncr Enna�: JacobK@holmber co.com <br /> BUILDING PERMIT APPLICATION <br /> Existin Use of Buildin : Contract PHce of Work:3 1400 <br /> Pro osed 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 ❑Remodei �Re air ❑T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: �G�,v�� �o� �1��„J,�.�� �N 4� �� l� � �` _,�•a� <br /> Gr,�.��, � a .,.�� <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> MECNANICAL PERMIT APPLICATION PI.UMBING PERMiT APPI1CATiON <br /> Type of Project: New Addn X Alteration _Repair Type of Project: New Addn AlteraHon _Repair <br /> #of �,�st of Fixtures �°f tFst of Ff�ur�es #°f Lfst of Fixtures �°f l,lst of�xtures <br /> Fixtures Ffxtures Fficfures Flrtures <br /> PJC—Air Handiin UNts Heat Pump 7oilet Backflow Preventer Inside Bld <br /> Forced Air S tems Unit Heater Bathtub Urina1 <br /> Gas Pi in Soiler Lavato ash Basin Drinkin Four�tain <br /> Water Heater Refrigeraiion Shower Fi�r Dtain <br /> Gas Fire lace Wood Stove Kitchen Sink 8�Dis osal Grease 7ra <br /> Gas Ran e Ducting 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(Service/Bar/Mo etc. Uther. <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT.•1 have reviewed fhis applkaGon and conRrm the informetion contalned herein ls We and correct.Wak done pursusnt to this permit must comply wJth <br /> cument federel,state,and/ocal law. The granting of a permit only authorizes approved work and no deviations thereham.Deviatia+s must frrst be authorized+n w�iting fmm the <br /> Building Of!'iciaf before being authorized under any ci�cumstance.i am the owner,or 1 am authorized by the owner of this property to periorm the worlc ior whkh application is made, <br /> and 1 compiy with the State Contractors Lew 18.27 RCW and 296.200A WAC. <br /> City of Fverett Olficiat Use Only <br /> � ���� PERMIT# w O <br /> � � <br /> dwnedAutharized Astent Sipnature Date (Revised 9l?3/2t)1fi) <br />