1323 BRUSKRUD RD 2018-10-24 - Laserfiche WebLink

3rDN3I.. PERMIT APPLICATION' BUILDIN CHANICAL/PLUMBING /SIGN I 'WINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©everettwa.gov l www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1300 100th PI SE A, Everett, WA 98208 PROPERTY TAX#: 28051900101700 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Trailside Preservation LP TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 21515 Hawthorne BLVD. Suite 390 CITY Torrance STATE WA ZIP 90503 OWNER PHONE: 310-802-6682 OWNER EMAIL: Nick@Preservationpartners.org CONTRACTOR NAME: Holmberg Company CONTRACTOR ADDRESS: STREET 1128 8th st CITY Kirkland STATE WA ZIP 98033 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): HOLMBC*066ME CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 051003 PRIMARY CONTACT: 0 OWNER I CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Jacob Klein CONTACT PHONE: 425-602-7370 CONTACT EMAIL: JacobK@holmbergco.com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 4200 Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Duct Work from range hoods only. New exhaust Fans not Provided or installed by uS. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn X 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 A/C—Air Handling Units Heat Pump 12 Toilet Backflow Preventer(Inside Bldg)' Forced Air Systems Unit Heater 1 2 Bathtub Urinal Gas Piping Boiler 12 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration 18 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 12 Range Hood 12 Water Heater 2 Other: Hose Bibs 12 Exhaust Fan Sink(Service/Bar/Mop/etc.) 4 Other: ADA Showers SPRINKLER/SUPPRESSION SYSTEM 'Chemical or Water ' No.of Heads ACKNOWLEDGEMENT:l 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.I am 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 P RMIT (4 ( /�7 a3 20 Owner/Authorized Agent Signature Date (Revise 9/23/2016)