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PERMIT APPLICATION <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 1 FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> B biiiii**ack Ink Only:Pleas . PRI,JE1 T,SITE INFORMATIOM!I ,k ,` :.; . f <br /> PROJECT SITE ADDRESS: 82 4 WEST CASINO ROAD ( t D6 C) PROPERTY TAX#: 00392100000700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> InnainagamingletalannentaiNtliditi*OIRM#10WEIRMONEMERNMOMO <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 /> CITY BELLEVUE STATE WA ZIP 98004 <br /> OWNER PHONE: 425-454-8205 OWNER EMAIL: COREY BALDWIN <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): ROCHLCS 8 9 I PPCITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: D OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 415-578-5562 <br /> TESSA LOMBARDI <br /> CONTACT EMAIL: tlombardi@basisarch.com <br /> MENESSOMISBEENEMIENEBWomoiookotropodiolowimentageSENNEWOMEM <br /> Existing Use of Building: /9l0l0r- Contract Price of Work:$_ '7$(1,0 <br /> Proposed Use of Building: " Heat Source: !Was • DElectric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex Multi-Family-#of Units: 93 ..:commercial ❑Industrial <br /> Type of Project: ONew ❑Addition El Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ®Change of Use <br /> DESCRIPTION OF WORK: <br /> BUILDING EXTERIORS: (N)FIBER-CEMENT SIDING WIHT CORRUGATED METAL ACCENTS, WINDOW REPLACEMENT, DRY ROT REPAIRS,FULL PAIPT <br /> AT EXTERIORS, <br /> INTERIORS:DRY WALL REPAIRS,PAINT,FLOORING, COUNTERTOPS, APPLIANCE AND FIXTURE REPLACEMENT. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> IF SME, HANiCAL PERMIT APPL,ICATICIN. :. .`.'..: iaMWIMNkS*Mijgtj0SS1RMttOSAC*OWMBNMPBI <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 /> ` PRIN ETf I#UPORESSEItM, it.: �10. F <br /> Chemical or Water , \No.of Heads <br /> 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 <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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State C•ntractors , R .296.200A WAC. <br /> City of Everett Official Use Only <br /> '/ :0/'" PERMIT# <br /> Owner thori •d Agent Signature Dat- (Revised 9/23/2016) <br />