978 W CASINO RD 2019-01-11 - Laserfiche WebLink

PERMIT APPLICATION BUILDINCHANICAL/ PLUMBING /SIGN RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES ______' 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits 441.1e r la+ 0+thOJYR+ PROJECT SITE ADDRESS: 900 W Casino RD vt 7j PROPERTY TAX#: 003921-000-004-01 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) OWNER NAME: Parkside Acquisition Preservation TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 21515 Hawthorne BLVD STE 395 CITY Torrance STATE CA ZiP 90503 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Holmberg Co. CONTRACTOR ADDRESS: STREET 1128 8th St E CITY Kirkland STATE WA ZIP 98033 CONTRACTOR PHONE: 4258222233 CONTRACTOR EMAIL: JacobK@holmbergco.com CONTRACTOR LICENSE#(REQUIRED): HOLMBC*066ME CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 051 003 PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas ❑Electric CI Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial Type of Project: ❑New DAddition ®Remodel ❑Repair DTA. ❑Sign El Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Replacing Fixtures Like for Like with no Modification to Rough in. ASSOCIATED BUILDING PERMIT#(if applicable): f ,00101)0 ► RM TOW Off.- . .x I _ ))tiM %, Win V:M Type of Project: _New _ Addn Alteration _Repair Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler _ 4 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan 4 Sink(Service/Bar/Mop/etc.) Other: Chemical or Water I No.of Heads 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 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 Building Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Il O r DeO\ Owner/Authorized Agent Signature Date (Revised 9/23/2016)