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• <br /> 4 <br /> PERMIT APPLICATIOI— <br /> BUILDING /MECHANICAL/ PLUMBING /SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> Stiiii.oIr Black#It ( my PXaase SECT SIT I ORMAT+> ,:' r, .: <br /> PROJECT SITE ADDRESS: 824 WEST CASINO ROAD �BO ROPL.tTY TAX#: 00392100000700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ARMUNONMENSMS.1.Mtaigatgg000001t <br /> OWNER NAME: TENANT NAME(If Commercial):CASINO-WESTMONT AFFORDABLE <br /> OWNER MAILING ADDRESS: STREET 2223 112TH AVE. NE, SUITE 102 HOUSING PARTNERS, LLLP <br /> Cm( BELLEVUE STATE WA ZIP 98004 <br /> OWNER PHONE: 425-454-8205 OWNER EMAIL: COREY BALDWIN <br /> ,.,..:.. t .. <br /> CONTRACTOR NAME: SRI-ROCHLIN CONSTRUCTION SERVICES JV, LLC <br /> CONTRACTOR ADDRESS: STREET 2223 112TH AVE. NE, SUITE 102 <br /> CITY BELLEVUE STATE WA ZIP 98004 <br /> CONTRACTOR PHONE: 425-681-6894 CONTRACTOR EMAIL: rochjimms@comcast.net <br /> CONTRACTOR LICENSE#(REQUIRED): ROCHLC SB 9 IPP CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 415-578-5562 <br /> TESSA LOMBARDI <br /> • CONTACT EMAIL: t1ombardi@bassarch.com <br /> ._ BUILDING PE #T PP"LI ATI 11 <br /> Existing Use of Building: GARAGE/ STORAGE Contract Price of Work:$ Se-1-04-7-0-0=e) t?-O rtid o <br /> Proposed Use of Building: COMMUNITY BLDG Heat Source: ®Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial <br /> Type of Project: ❑New 14ddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ISIChange of Use <br /> DESCRIPTION OF WORK: (ek.wa Nouse) <br /> CONVERT EXISTING SINGLE STORY GARAGE BUILDING PRESENTLY USED FOR MAINTENANCE STORAGE INTO COMMUNITY BUILDING WITH LEASI <br /> OFFICE, ACCESSIBLE RESTROOM & KIT CE ROOM. '. - --. •• _ - - -, _- <br /> '.--ri+ a (y'Mt Klir p1&(1IL I FLASHING STROBE <br /> ASSOCIATED BUILDING PERMIT#riral5rte-dblej. <br /> MECHANICALPERRMIT APP1,I AT1ON PLUMBING PER.MIT APPLICATION_± .. <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: New _Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air.Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap , <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> S NK,Lltt l S IP'RESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />