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� t�unding #y�4 � <br /> PERMIT APPLICATION <br /> BUILDING /MECHANICAL!PLUMBlNG /SIGN /�NI{LER/ 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.evereriwa.govlpermits <br /> (Blue or Black lnk Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 900 W Casino RD, Everett, WA 98204 PROPERTY TAX#: 0039Z'I OOODO4O� <br /> LEGAL.for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description} <br /> CONTACT INFORMATION <br /> OWNER NAME: TPIIISICIB PI'@S@I'V$t10C1 LP TENANT NAME(if Commercial): <br /> OWNER MAl1.ING 14DDRE5S: S�E� 21515 Hawthorne BLVD. Suite 390 <br /> �,� Torrance STATE WA Z� 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick Preservation artners.or <br /> coNTw►cTOR NaME: Holmberg Company <br /> CONTRACTOR ADDRESS: srne� 1128 8th st <br /> o�„- Kirkland STATE WA Z� 98033 <br /> CON7RACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED}: HOLMBC*066ME C1TY OF EVERETT BUSINESS LICENSE#(REQUIREQ): Q51003 <br /> PRIMARY CONTACT: O OWNER �CONTRACTOR ❑OTHER{Please Specify) <br /> CONTACT NAME: JaCOIJ KI@ICl CONTACT PHONE: 1�2rj-�OZ-737O <br /> CONTACT EMAIL: J�COI�K C' IIOII'Ytb@t' CO.com <br /> BUILDING PERMIT APPLICATION <br /> Existin Use of Buiidin : Contract P�ice of Work:; 1400 <br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T : ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famii �of Units: ❑Commercial ❑industrial <br /> T e of Pro'ect: ❑New ❑Addition ❑Remodei DRe air ❑T.I. ❑Si n �S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: ���,,,,`��� ���„� ���,�� �„4� �� 1� � ���'o� <br /> Gh�.��, �� ° <br /> ASSOCIATED BUILDING PERMtT# if a ticable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> ype of Project. New Addn X Alteration ,,,,_ltepair Type of Project: New Addn Alteratfon _Repair <br /> #of �ist of Ffxlures #°f Ust of�xtures #°f List of Fixdrres #of List of Fixtures <br /> Fixtures Fixtures Fixtures Flxtures <br /> AJC—Air Handlin Units Heat Pump Toilet Backflow Preverrter Inside Bid <br /> Forced Air S tems Unit Heater Bathtub Urinal <br /> Gas Pi in Boifer Lavato ash Basin Drinkin Fountain <br /> Water Heater Refi eration Shower Fioor Drain <br /> Gas Fire lace Wood Stove Kitchen S�nk�Dis asal Grease Tra <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes D er Hooku s Other. Clothes Washer Medicai Gas <br /> Ran e Hood Water Hea#er Other: <br /> Exhaust Fan Sink Service/BarlMo /etc, Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chernical or Water No.of Heads <br /> ACKNOWLEDGEMENT.•1 have reviewed thls app/ication and con�irm the fnformation cantalned herein/s trus snd conect.Work done pursuant to this pesnit must compJy with <br /> current federal,state,and loce!/ew.The granting of a permit only authorizes approved work and no deviations therefrom.DeviatJons must first be authorized in writing from the <br /> Building O/ficia!before being authorized under any circumstance.!am the owner,or i am authorized by the owner of thls properfy to pedorm the wak tor whlch application is made, <br /> and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Cky of Eve�ett Oft'iciaf Use Only <br /> .� ���/I_� PERM IT# ' <br /> 6 <br /> OwnerlAuthorized A�ent Sipnature Date 1Revfsed 8/23✓2096) <br />