Laserfiche WebLink
� t�ui�ding �y56 � <br /> PERMIT APPLICATION <br /> BUILDING I II�CHANICAL/PLUMBING J SlGN ! II�tINKLER I 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( www.everettwa.gov/permits <br /> (Biue or Black Ink Only Please) PRt}JECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 9OO W CaSit10 RD, Everett, WA 98204 pl20PERTY TAX#: 00392100000401 <br /> LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TPaIISICI@ PCG'S@IVatlOtl LP TENANT NAME(If Commercfal): <br /> OWNER MAILING ADDRESS: S�E� 21515 Hawthorne BLVD. Suite 390 <br /> �m Torrance STATE WA ��P 90503 <br /> OWNER PHONE: $10-802-6682 OWNER EMAIL: Nick Preservation artners.or <br /> coNrRa,croR Nan�E: Holmberg Company <br /> CONTRACTOR ADDRESS: srnEET �128 B�II St <br /> �m Kirkland STATE WA Z�P 98033 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR UCENSE#(REQUIRED): HOLMBC*066ME CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): OS1 003 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER{Please Speaify) <br /> CONTACT N/4ME: JaCOI� KI@Itl CONTACT PHONE: t�,7�j-��Z-73]'{) <br /> CONTACT EMAIL: ,lacabK�a holmber co.com <br /> BUt1.DING PERMIT APPLICATION <br /> Existin Use of Buildin : Contract Price af Work:a 1400 <br /> Pro sed Use of Buildin ; Heat Source: ❑Gas DElectric ❑Other <br /> Buildin T : ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil �of Units: OCommercial ❑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: yL�,v�� �a� ��(Ja.�,,, �N 4� �� i� � ���"o� <br /> Gr�.��, ;:.� �., ° <br /> ASSOCIATED BUILDING PERMIT# if a licable: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPUCATION <br /> Type of Project: _New ,,,,_ Addn X Alteration _Repair Type of Project: _New Addn Alterotion _Repair <br /> #of Lisf of�xtures #of �st of Fixtures #of ust of Ffxh►res #of ��,y��Fj�ures <br /> �xtures Fixtures Ffxtures Flxtares <br /> A!C—Air Handlin Units Heat Pump 'toilet Backflow Preventer Inside Bld <br /> Forced Air S tems Unit Heater Bathtub Urinai <br /> Gas Pi in Boiler Lavato ash Basin Drinkin Fountain <br /> Water Heater Refri eration Shower Fl�r Drain <br /> Gas Fire lace Wood Stove Kitchen Sink&Disposal Grease Tra <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes D er Hooku s Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/BaNMo /etc. Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT.'f have revtewed this appfication and confirm the fnformation contained here(n Is true and correct.Work done pursuani to this permit must comply wlth <br /> cument federaf,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized fn writing fiom fhe <br /> Building Otficiaf before being authorized under any circumstence.1 am the owner,or I am authorized by the owne�of this property to perform the work tor whlch application is made, <br /> and!comply with the State Contractors Law i8.27 RCW and 296.200A WAC. <br /> City of Everett O�ciaf Use Onty <br /> I/�/`/" ��Z�� PERMIT# <br /> � -O�C� <br /> OwnerlAuthorized As�ent Siunature Date (Revised 9/23/2016) <br />