942 W CASINO RD 2018-04-20 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov( www.everettwa.gov/permits {Blue or Btaek inK On1y Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 942 W Casino RD PROPeRnr Tax#: 003921-000-004-01 LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long lega[description) CONTACT INFORMATION OWNER NAME: Pal'kSIC�@ AC uisition Preservation TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srneer 21515 Hawthorne BLVD STE 395 ��TM Torrance STATE CA Z�P 90503 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: HOICTIIJeI' Co. CONTRACTOR ADDRESS: s�raaeer 1128 8th St E �� Kirkland STA� WA Z�P 98033 CONTRACTOR PHONE: 42'rJH22Z233 CONTRACTOR EMAIL: �aCObK�IlOICTIb@t'gCO.COCTI CONTRACTOR LICENSE#(REQUIRED): HOLMBC*066M E CITY OF EVERETT BUSINESS LICENSE#(REQUIRE : O�J1 003 PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION : • Existing Use of Building: Contract Price o�Work:$ CJ Proposed Use of Building: Heat Source: '�Gas ❑Electric ❑Other Building T pe: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: mercial ❑Industrial T pe of Pro'ect: ❑New DAddition �Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: Replacing Two Boilers � A „ � g�� �CIdU ASSOCIATED BUILDING PERMIT# if a licable: MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION: Type of Project: _New Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of list of Fixtures #of List of Fixtures #of List of Ffacfures #°� Lisf of Fixfures Fixtures Fixtures Flxtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bld ) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping 2 Boiler Lavato Wash Basin Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Ran e Ductin Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other. SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No.of Heads ACKNOWLEDGEMENT.�!have reviewed this application and confirm the information contained herein is true and correct WorR done pursuant to this permit must Comply with current federal,state,and local law.The granting of a pennit on/y authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building O�cia/before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this properfy to perform the wo�ic for which application is made, and 1 comp/y wfth the State Contractors Law 18.27 RCW and 296.200A WAC. � City of Everett Official Use Only �J ''f �l� �/ l I / � ? PER # � � � � Owner/Authorized A gnature Date (Revised 9/23/2016)