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PERMIT APPLICATIO <br /> sly__' , BUILDING ECHANICAL/ PLUMBING/SIGN,INKLER/ 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 I www.everettwa.gov/permits <br /> (Blue or Black IInk,Only,Please) PROJECT SITE INFORMATI©N, _- 3 <br /> PROJECT SITE ADDRESS:3105 Pine Street PROPERTY TAX#: 00439075000100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> , . CONTACT INFORMATION <br /> OWNER NAME: Hollander Investments TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 119 N Commercial Street#165 <br /> CITY Bellingham STATE WA ziP 98225 <br /> OWNER PHONE: 360.647.1916 OWNER EMAIL: Serj@hollanderinvestments.com <br /> CONTRACTOR NA : OWner <br /> CONTRACTOR DRES • STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 8 OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: 206.708.1682 <br /> David Murphy CONTACT EMAIL:dmurphy@murphyvarey.com <br /> BUILDING PERMIT APPLICATION . " "" <br /> Existing Use of Building: Hotel Contract Price o ork:$ "®f b1') <br /> Proposed Use of Building: Hotel Heat Source: ❑Ga Elootric er <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: TL)Commercial ❑Industrial <br /> Type of Project: El New DAddition DRemodel ❑Repair ❑T.I. CI Sign ❑Sprinkler El Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Guestroom Renovation - North Wing <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION _ PLUMBING PERMIT APPLICATION' <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 /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number 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•• ':'al 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 co . 4 it'h the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 1117(zi� PicCI-6 <br /> Owner!' I horized Agent Signature Date (Revised 9/23/2016) <br />