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� Building #946 � <br /> PERMIT APPLICATION <br /> BUILDING /MECHANICAL/ PLUMBING/SlGN !�NKLER! DEMOLITION <br /> CITY QF EVERETT PERMIT SERVICES <br /> 32D0 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)eve�etteps@everettwa.gov� www.everektwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 9OO W C3SIn0 RD, Everett, WA gHZO4 PROPERTY TAX#: 00392100000401 <br /> LEGALfio�new consfruction: Short PlaVsubdivision Lot Na. (attach copy of long legal descripUon) <br /> CONT�4CT INFORMATION <br /> OVYNER NAME: Trailside Preservation LP TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: S�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,� Torrance STATE WA Z�P 90503 <br /> OWNER PHONE: �1 O-�SOZ-6fi82 OWNER EMAIL: Nick Preservation artners.or <br /> coNT�►cTOR Nauie: Holmberg Company <br /> CONTRACTOR ADDRESS: STREET 1128 8th st <br /> ��„� Kirkland STA,� WA z+P 98033 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#{REQUIRED}: HOLMBC*066M E CITY OF EVEF2ETT BUSINESS LICENSE#(REQUIRED): O�J1 003 <br /> PWMARY CONTAGT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> C�NTACT NAME: J�COI� KI@ICt CONTACT PHONE: 4,2�j-�(j�-]37O <br /> coNracT eMa�: �acobK ar holmber co.com <br /> BUIi.DING PERMIT APPLICATION <br /> Existin Use of Buildin : Contract Price of Work:; 2100 <br /> Pro sed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T : ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#ofUniks: ❑Commercial ❑Industrial <br /> T of Pro'ect: ❑New ❑Addition ORemodel ❑Re air OT.I. ❑Si n �S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: yG�,.Lo,�� �.o� �,��,�.R� ���� �� 1�, ,1,,.� ��'a�— <br /> Gh�'��, �� o i v�.� <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ot Proje�t. _New Addn X Alteration _Repair Type of Project: New _Addn Alterafion _Repair <br /> #of �,jst of Fixtures #°f List of�irte�res �°� Lrst of Flirttrres #of List of Ffxtures <br /> Fixtures Fixtures Ffirtures Flxtures <br /> A!C—Air Handlin Units Heat Pump Toilet Backflow PreveMer{Inside Bld <br /> Forced Air S tems Unit Heater Bathtub Urinal <br /> Gas Pi in oiler Lavato ash Basin Drinkin Fountain <br /> Water Heater R ' eration Shower Ftoor Drain <br /> Gas Fireplace W Stove Kitchen Sink 8�Dis osal Grease Tra <br /> Gas Ran e D ctin Dishwasher Roof Drains <br /> Clothes D er Hooku s her. Clothes Washer Medical Gas <br /> Ran e Haad Water Heater Other: <br /> Exhaust Fan Sink(ServiceBar/Mo letc. Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed thls applfcaUon and confirm the information contalned herein Is true and conect.Wak done pursuani to this pe�m8 must comply wlth <br /> curreni federsl,state,and local law.The granting of a permH only authorizes approved work and no deviatrons therefrom.Deviallons must first be authorized in writing from the <br /> Building Official before being authorized under any ctrcumstance.f am the owner,or!am aulhorized 6y the owner of thJs properfy to peAorm the work for whkh applicafion is made, <br /> and J comply with!he State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Cfty of Evenett Off'iciaf Use Only <br /> /�//�z _ //��A^- ����/^ PERMIT# ^ ��( <br /> �/�� / /v �, 6 ) ` <br /> / �c, � <br /> OwnedAutho�ized Aaent Sipnature Date (RevJsed 9I23/2096) <br />