Laserfiche WebLink
� �u�ia�ng �ys� � <br /> PERMIT APPLICATION <br /> BUILDING /MECHANICAL/PLUMBING /SlGN J S INKLER/ DEMOLITIQN <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.gav� wvrw.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATIQN <br /> PROJECT SItE ADDRESS: 9OO W C1SIC10 RD, Everett, WA 98204 PROPERTY 7AX#: 00392'I O0OOO4Q'I <br /> LEGAL for new construcGon: Short PlaUsubdivision Lot No. (attach copy ot long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Trailside Preservation LP TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: S,�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,� Torrance STAlE WA Z�P 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick Preservation artners.or <br /> coNTww�croR NaHE: Hoimberg Company <br /> CONTRACTOR ADDRESS: srnEEr 1128 8th st <br /> �� Kirkiand STATE WA Z�P 98033 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#{REQUIRED): HOLMBC*O�6ME CITY OF EVERETT BUSINESS LICENSE#{REQUIRED): OFJ1 003 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER{Please Specity) <br /> COMTACT NAME: JaCOIJ KI@Itl COi+�'fACT PHONE: 42�J'-6OZ-737O <br /> CONTACT EMAIL: JacobK�hoimber co.00111 <br /> BUILDINt3 PERMIT APPLICATION <br /> Existin Use of Buildin : Contract PNce of Work:; 1400 <br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑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 DChan e of Use <br /> DESCRIPTION OF WORK: yL�„`,��'� �,��„� ��(�,�.n„ �N 4� ��ds � �J�..�'�'o� <br /> Gr�.��, � � <br /> ASSOCIATED BUILDING PERMIT# if a licable: <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMlT APPLICATION <br /> Type of Project: _New Addn X Alteration _Repair Type of Project: _New Addn Alteration _Repair <br /> #of Ust of Fxtttres #�f List of Fixtur�es #°f Liat of Fi�ctures #°f List of Fixtures <br /> Fixhires Fixtunes Fi�ntures Flxtures <br /> A/C—Air Handlin Units Heat Pump Toilet Backflow Preventer Inside Bid <br /> Forced Air S stems Unit Heater Bathtub Unnal <br /> Gas Pi in Boiler Lavato ash Basin Drinki Fountain <br /> Water Heater Reiri eration Shower Fioor Drain <br /> Gas Fire lace VVood Stove Kitchen Sink 8 Dis sai Grease Tra <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes D er Hooku s Other. Clothes Washer Medical Gas <br /> Ran e Hood Water Heater Okher: <br /> Exhaust Fan Sink Service/BartMo /etc. Other: <br /> SPRINKLER!SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT:f have reviewed this application and conBrm the informaUon contained hereln Is frue aRd conect.Wwic done pursuant to this permit must comply wlth <br /> current iederal,state,and ioca!lew.The granting of a permit only authorizes approved work and no deviations thereirom.Devfatlons must first be euthorized in writing fiom the <br /> Building Official before being authorized under any circumstance.1 am the owner,or I am authori2ed 6y the owner of this property to perlorm the work for whlch application is made, <br /> and!comply with the State Contractors Law 18.27 RCW and 296.200A W/IC. <br /> Cky of Everett O�cia!Use Only <br /> � � � i PERMIT# ^�� <br /> I <br /> ner/Authorized Aaent Sis�nature Date (Revised 9/23/2016) <br />