Laserfiche WebLink
P ��� <br /> ERMIT APPLICATION <br /> BUfL.DiNG/MECHANlCAL 1 PLUMBING 1 SIGN I SPRINKI.ER/DEMOLITlON <br /> CITY QF EVEREIT PERMR SERVICES <br /> 3200 CEDAR STREET,EVERE7T,WA 98201 <br /> (P)425-257-$810 � FAX 425-257-88fi7 f(E}evereltaps�everetlwa.gov� www.evereMaa.gov/permits <br /> (Bla�or Black Ink Oni Plsase PR�J�CT SITE INPORMATION <br /> PRWEC7 31TE ADDRESS: W C�Sltl(3 D PROPERi'Y TAX i�: (}(�����-{��{)-g(}t�-()'� <br /> LEGAL for new construction: SAort PlaUsubdlvision LoR No. (attach copy af long Iegal descriptionj <br /> Cl�NTACT lNfORMATION <br /> OWNER NAME: p�r{��{�� ac uisition Preservation �r�r NAINE lf Cammercial). <br /> OWNER MAILIN(i ADDRESS: srRr�r 2151� Hawtharne BLVD STE 395 <br /> �� Torrance �A� cA �P 9a5o� <br /> OWNER PHONE: QWNER�MAIL: <br /> COMTRACTOR NAAAE: Holmber Ca. <br /> caNrw►croR aao�ss: �E� 1128 8th 5t E <br /> �� Kirklane� $TATE WA Z� g8033 <br /> CQNTRAC70R PHQNE: ���$2����� CON7RACTOR EMAIL: Ja�abK�holmber ca.Gt3Ctl <br /> CONTRACTOR I.ICENSE#{REQIlIRED): NC7LMBC'`(���ME CITYOF EVERETT BUSINESS LIC�NNSE�I(REqUfI�ED): C��J1 EJ{�� <br /> PRIMARY CONTAC'1': 0 OWNER I$I CQN'I'RACTOR ❑OTHER{Please Specify) <br /> CON7ACT NAAAE: CQNTACT PHON@: <br /> CONTACT�MAIL: <br /> BUILDING PERMIT APPLICATlR�N . <br /> Existin Use of Buildin : Contract Prica cf Woric S '�+ <br /> Pr osed Use of Buildin : Heak SourcB: �Ges C.1Electric DOther <br /> Buildin T : OS�R-Detached OSFR-Attached �Da lex OMutd-Fsmil -#of Units: �ICommercfal ❑fndustrial <br /> T e of P 'ect: ONew �Addi�on �Remodel OR afr OT.I. C75f n �S rfnlder C1Demolftfon (�Chsn e of Use <br /> DESCRIP'F'ION OF WORK: R����cing Two Toilets and Lavatories and Showers <br /> �� � � O .... ��� <br /> ASSOCIATED BUILDiNti PERMIT!! if a Ilcable: <br /> MECHANICAL PERMIT APPLfCAT10N '' PLUM81NCi.PERMfT APPI.YCATION � • <br /> YPe oi Project ,,,_,Naw _ Addn Akeratio�t�Repak '{yp�of ProJsct: _Nwr A1ddn AINraNbn `ttepatr <br /> Ftar�ros Liat of Fhrfruas F�� Ltat of HxWns F►xeures Ust of FBchrres �� Lfat of F6cGrres <br /> AJC—Air Handli Units Heat Pum 2 Toilet Backflow Preventer Inside Bid <br /> �orced Air 5 stems Unit Heater Eiathtuh Urinal <br /> Gas PI in Boil�r Z Lavato ash Basin Drinkf Fountain <br /> Water Heater Re erat�n � Shower Floor brain <br /> Gas Ft lace Wood Stqve Kitdten Sink&Dis sal Gre�e Tra <br /> Gas Dudi Dishwasher ltoof Drains <br /> C�othes D H Other: qothes Washer Medical Gas <br /> Ran e Hood Water Heater Other. <br /> Exhaust Fsn Sink Service/Bar/ etc. Oiher: <br /> $PRINKI.ER/SUPPRE3SION SYSTEM . `` <br /> Chemica!or Water Na.of Heads <br /> AClWOVYLEDGEMENT.•1 heve ravlewed tMs appl(cetion end conthm the�nfomretlon coMalned herein Fa Lue and aarect Worlc dorw pursuant to iJris pe►mH muat cwnply wlth <br /> cumant federaJ,atate,snd 1�1 Aaw.T7re g�anWig of e permlt anly eutho�ms app�py+edµ,ork e�no devi�lons therehom.Devfellar+s rrwst flist be aulhaized!n wrlNng from tha <br /> Brdldln9 OfRcinl befo�e beln9 authorimd under any dreumstancg.i am the aMrner,or!am euthw)zed by ths owner of N�s proAeRy to pedam ihe wwk for whfch epplfcation/s msde, <br /> and 1 comply wlth the Sfate Contrectora Law f8.27 RCW anof 296.20LL4 WAC. <br /> Clly o1 Everett OA'lcief Use O�y <br /> ����/Ir7 ��R� � Q C� l <br /> Owner/ uthorized Aqent Ignature Dete (Revlser! 3/2 6J <br />