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� t�uuding �y�o � <br /> PERMIT APPLICATION <br /> BUILDING I■IIIICHANICAL/PLUMBING /SIGN /�INKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX d25-257-8857 �(E)everetteps@everettwa.gov( www.everettwa.gov/permits <br /> (Biue or Black Ink tanly Please) PRD.�ECT SITE IN�ORMATION <br /> PROJECT SITE ADDRESS: 900 W Casino RD, Everett, WA 98204 PROPERTY T/UC#; 00392100000401 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. {attach copy of long legal description} <br /> CONTACT INFORMATION <br /> OWNER NAME: TPaIISICI@ PCeS@NatlOn LP TENANT NAME(ff Commercial): <br /> OWNER MAILING ADDRESS: S�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,TM Torrance STATE WA �� 90503 <br /> OWNER PHONE: 310-802-Gs$Z OWNER EMAIL: Nick Preservation artners.or <br /> coNTw►croR N,vu�e: Holmberg Company <br /> CONTRACTOR ADbRESS: sraEEr 112$ 8th st <br /> �m Kirkland STA� WA Z� 98033 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR UCENSE#(REtdUIRED): HOLMBC*066M E C1TY OF EVEREIT BUSINESS UCEN8E#(REQUIRED): O�J100.3 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> C�NTACT N/4ME: JaCC1IJ KI81C1 CONTACT PiiONE. 425-602-7370 <br /> CONTACT EMAIL: JaCobK a�holmber co.com <br /> BUtLDING PERMlT APPLICATION <br /> Existin Use of Buiidin : Contraat Price of Work:3 1400 <br /> Pro sed Use of Buildin : Heat Source: OGas ❑Electric ❑Other <br /> Buildin T : ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T e of Pro'ect: ❑New �Addition ❑Remodel �Re air ❑T.I. ❑Si n �S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: �,G���� �o� ���,�,rt., �N 4� �� t� � �+ _'�'o�- <br /> O �"ca <br /> Gh�'��, ..� �.� <br /> ASSOCIATED BUILDING PERMiT# if a licable: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: oNew Addn X Alteration _Repair Type of Project: �New _Addn AlferaNan _Repafr <br /> #�f Lfsf of FFactures #°f List of�xtures #of Llst of Fixtures �°f tist of Fixtures <br /> Fixtures Fixfures Ffi�ures Flirtures <br /> A/C—Air Handiin Units Heat Pump Toilet Backflow Preverrter Inside Bid <br /> Forced Air S tems Unit Heater Bath#ub Urinal <br /> Gas Pi in Boiler Lavato ash Basin Drinki Fountain <br /> Water Heater Refri eration Shower Fioor Drain <br /> Gas Fire lace Wood Stove Kitchen Sink&Dis osal Grease Tra <br /> Gas Ran e Ducting Dishwasher Roof Qreins <br /> Clothes D er Hooku s Other. Clothes Washer Medical Gas <br /> Ran e Hood Water Heater �ther. <br /> Exhaust Fan Sink(Service/BaNMo letc. Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKlVO4VLEDGEMENT:l have reviewed this epplfcaGon and confirm the informatian conteined here(n is true and corract.Work done pursuant to this permit must comply wlth <br /> current iedera/,state,and Mcal law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be euthorized in writing fiom the <br /> Building Officiat before 6eing authorized under any circumstance.I em the owner,or!am authorized by the owner of th/s property to perform the work for whlch application is made, <br /> and!compfy with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Oficial Use Only <br /> � �/� //'�' PE�#�� _�'"�. � <br /> ! � ' � <br /> UwnerlAuthorized A�aent Sipnatu Date (Revised 9/23/2016) <br />