1317 BRUSKRUD RD 2019-01-24 - Laserfiche WebLink

\r7j\- PERMIT APPLICATIO '1I BUILDIN MECHANICAL 1 PLUMBING /SIGN I Il>■A■I'i:INKLER 1 DEMOLITION 4414 ' ' CITY OF EVERETT PERMIT SERVICES . 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govtpermits (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 erry 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 1/(REQUIRED): 051003 PRIMARY CONTACT: 0 OWNER 171 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: ❑Gas ❑Electric ❑Other Building Type: DSFR-Detached ❑SFR-Attached CI Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition CI 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 12 Bathtub Urinal Gas Piping Boiler 12 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration 18 Shower Floor Drain Gas Fireplace Wood Stove IGtchen 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: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 1 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 16.27 RCW and 296.200A WAC. ^7City of Everett Official Use Only eilA la2, �7/'/ PE,rk#gcS -011- Owner/Authorized 011- Owner/Authorized Anent Signature Date (Revised 9/23/2016)