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( �u�ia�ng �yoz � <br /> I PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN 1 �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( wuvw.evereiiwa.gavlpermits <br /> (Blue or Black Ink Oniy Please) PROJECT SITE INF�RMATION <br /> PROJECT SITE ADDRESS.� Casino RD, Everett, WA gH�O� PROPERTY TAX#: 00392100000401 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. ;{attach copy ot long legal description) <br /> S� CONTACT INFORMATION <br /> OWNER NAME: �dg PCgSBNatl011 LP TENANT NAME(ff Commercial): <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 /> coNrRacroR Nnrr�e: Hoimberg Company <br /> CONTRAGTOR ADDRESS: srneeT 1128 8th st <br /> �m Kirkiand STATE WA =�P 98033 <br /> CONTRAGTOR PHONE: CONTRACTOR EMAIL.: <br /> CON7RACTOR UCENSE#(REQUIRED}: HOLMBC*O66ME C1TY OF EVERETT Bt731NESS LICENSE#(REQUIRE : O�J1 O 3 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTQR ❑OTHER{Please Specify) <br /> CONTACT NAME: JaCOb KI@Itl CONTACT PHONE: ,42rj-6�2-]37Q <br /> CONTACT EMAIL: �acobKQa hoimber co.com <br /> BUILDING PERMIT APPtICAT10N <br /> Existin Use of Buildin : Contract Price of Work: 1400 <br /> Pro osed Use of Buildin : Heat Source: OGas ❑Ele c CiOther <br /> Buildin T : ❑SFR-Detached ❑SFR-At#ached ❑Du tex ❑Multi-Famii �of Uniks: ❑Commercial ❑Industrial <br /> T e of Pro'ect: ❑New ❑Addition ORemodel L3Re air ❑T.i. LlSign OS rinkler ❑Demolitfon ❑Chan e of Use <br /> DESCRIPTION OF WORK: 4L�►v��L �lar� �C��`�'R.� �.,y �o� <br /> Gr�.��. �e� ��dS. � P�r� . <br /> ASSOCIATED BUILDING PERMiT# if a licable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn X Altsration _Rapair 7ype of Project: New Addn _Alteratlon _Repair <br /> #°f i.fst of Fixtures #°; tFst of�xtures #of /,�st of�xtures �°t list oi FJxtures <br /> Fiartures Fixtures Fixtures Fbttures <br /> A/C—Air Handlin Units Heai Pump 7oilet Backflow Preventer Inside Bid j <br /> Forced Air S tems Unit Heater Bathtub Urir�a! <br /> Gas Pi in Boiler Lavato ash Basin Dnnkin Fountain <br /> Water Heater Reiri eration Shower F1ow Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Dis osal Grease Tra <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 �ther: <br /> Exhaust Fan Sink(ServiceBaNMo letc. Other: <br /> SPRINKLER/SUPPRESSlON SYSTEM <br /> Chemical or Water Na of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and conflrm the fntormation conta/nad herein fs true and correct.Work done pursuant to this parmit must comply wlth <br /> cument federal,state,and local law.The grsnting of a permit only authorizes approved work and no deviations therefrom.Deviatlons must frrst be authorized in wrifrng from the <br /> Building Olficial before 6eing authorized under any cfrcumstance.1 am the owner,or!am authorized by the owner of thk prope►ty to perform the work for whlch applicetion is made, <br /> and 1 comply with!he State Contractors Law 18.2�RCW and 296.200A WAC. <br /> City of Fverett Officia!Use Only <br /> PERMIT# <br /> /� "_ <br /> Owner/Autho ize Aaent Sipnatu�e Date (Revised 9/23/2a1S) <br />