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PERMIT APPLICATION <br /> fira 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 /> (Blue or i lacII Ink;Only Please) P OJECT SITE INFORMATION s g <br /> PROJECT SITE ADDRESS: 8 2 4 WEST CASINO ROAD C. ',i D6 4+0 PROPERTY TAX#: 00392100000700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATIO <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 /> ciiv 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 /> circ BELLEVUE STATE WA ZIP 98004 <br /> CONTRACTOR PHONE: 425-681-6894 CONTRACTOR EMAIL: rochjimms@comcast.net <br /> CONTRACTOR LICENSE#(REQUIRED): ROCHLCS 8 9 1 PP CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 415-578-5562 <br /> TESSA LOMBARDI <br /> CONTACT EMAIL: tlombardi@basisarch.corn <br /> l r ,'. ,. .. ` _ ,'.:14il# .)Ii"a:lI$rltll ',4 `P`41Cift`l"I0I N;_ <br /> Existing Use of Building: UTILITY ROOM/,yi rriF.. 3 Contract Price of Work:$. 1 r(D/ l 4o <br /> Proposed ADDITIONAL BEDROOM <br /> op d Use of ��Pl'3 Heat Source: ®Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached Duplex Multi-Family-#of Units: 10 ®Commercial ❑Industrial <br /> Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ®Change of Use <br /> DESCRIPTION OF WORK: Vt-(01- <br /> CONVERT UTILITY ROOM(COMMUNITY LAUNDRY ROOM)TO ADDITIONAL BEDROOM AT '_"'C_ 'C' UNITS. REMOVE WATER HEATER, INSTALL <br /> BASEBOARD HEATING, INFILL EXTERIOR DOOR AND PROVIDE (N) INTERIOR ACCESS. REPLACE FINISHES FOR RESIDENTIAL USE. <br /> *PLAN CHECKER NOTE: ALL UNITS ARE EQUIPPED WITH IN-UNIT LAUNDRY. 1UO2 it.e.410(&6 mod sAhluPO.A) <br /> ASSOCIATED BUILDING PERMIT#(if applicable): i2_ -pui-CE with I r Ce.44AAL. 12 t ra48,DfiAiT- <br /> MECHANICAL.PERMITtAPP .iCA ION PI.UMBIN PRiRM 1PPLiCsATIOi!i <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 /> i5PRINK .ERJ S'I, PPRESS.ION SYFS'i"EM' <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 /> Ow • Autho'ized Agent Signature Date (Revised 9/23/2016) <br />