Laserfiche WebLink
� Building #988 � <br /> III PERMIT APPLICATION <br /> BUILDING !M�CHANICAL/PLUMBING /SIGN /�—INKLER/ 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 9OO W CaSlf10 RD, Everett, �J�►9$2�� PROPERTY TAX#: 00392100Q00401 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TPaIISICIB PC@S@NStI0t1 LP TENANT NAME{lf Commercfal): <br /> OWNER MAILING ADDRESS: S�E� 21515 Hawthorne BLVD. Suite 390 <br /> �m. Torrance srn� W/�► ziP 90503 <br /> OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick Preservation artners.or <br /> coNTwacroR NaMe: Holmberg Company <br /> CON7RACTOR ADDRESS: STREET 1128 8th st <br /> �� Kirkland STA� WA Z�P 98033 <br /> CONTRACTOR PHONE: GONTRACTOR EMAI�: <br /> CONTRACTOR LICENSE#{RE4UIRED): HOLMBC*O�6ME C1TY OF EVERETT BUSINESS LIGENSE#(REQUIRED): O�J1 003 <br /> PRIMARY CONTACT: ❑OWNER �CONTRAGTOR �OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE; Q25_6O�-]37� <br /> Jacob Klein <br /> coNracr EM,v�: JacobK�«7hofmber co.com <br /> BUILDING PERMIT APPLICATION <br /> Existin Use of Buildin : Contract Price of WoHc:S 1400 <br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T : ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famil �of Units: ❑Commercial ❑Industrial <br /> T e of Pro ect: ❑New DAddition C�Remodel ❑Re air OT.I. ❑Si n OS rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: 4G�'r►v��(,.� ,��—lor� �C+�'�'R G�., �o� <br /> Gh�.��, � ��—' �4"dS. /t� �� ' <br /> ASSOCIATED BUILDING PERMIT# if a licable: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPI.ICATION <br /> Type of Project: _New Addn X Alteration _Repair Type of ProJect: New Addn Attsration _Repair <br /> #of Ust of�xtures #of �,}st of�xtur�es #°� List of Fr�res #°f List of Fixfures <br /> Fixtures Fuctures ' Ffxtures Flxtures <br /> A/C—Ai�Handlin Units Heat Pump Toilet Backflow Preventer Inside Bld <br /> Forced Air S tems Unit Heater Bathtub Urinal <br /> Gas Pi in Boiler �avato ash Basin Drinkin Fountain <br /> Water Heater Refri eration Shower Floor Drain <br /> Gas Fire lace Wood Stove Kitchen Sink&Dis osal Grease Tra <br /> Gas Ran e Ductin Dishwasher Roof Orains <br /> Clothes D er H�ku s Oiher. . Clothes Washer Medical Gas <br /> Ran e Hood Water Heater Other: <br /> Exhaust Fan Sink(ServicelBar/Mo /etc, Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT:!have reviewed fhls appfication and confirm the informaUon contafned hereln ts true and correct.Wwk done pursuani to this permit must comply wlth <br /> current iederal,state,and local law.The grarrting of a permit only authorizes approved work and no deviations therefrom.DeviaGons must first be authorized in writing fiam the <br /> Building Olficial before being eufhorized under any circumstance./am the owner,or t am authorized 6y the owner of thls proper�y to perform the work for whlch applicetion is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of EvereK O�cial Use Only <br /> ���� �/��l� PERMIT# <br /> � <br /> Owner/Authorized As�snt Sipnatu�e Date (Revised 9l 312 16) <br />