9930 EVERGREEN WAY THERAPEUTIC HEALTH SERVICES 2022-02-04

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1(E) everetteps@everettwa.gov I www.everettwa.gov/permits (Mun or sleek Ink OiM,y Pl"se) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 9930 Evergreen Way #A PROPERTY TAX #: 28041300306500 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Tong legal description) CONTACT INFORMATION OWNER NAME: THS Snohomish LLC TENANT BUSINESS NAME (Commercial): Therapeutic Health Services OWNER MAILING ADDRESS: STREET 1116 Summit Ave ciTv Seattle srATE Wa ZIP 98101 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: City Plumbing Inc. CONTRACTOR ADDRESS: smr EET 11432 47th Ave NE crrr Marysville STATE Wa Z,P 98271 CONTRACTOR PHONE: 360-661-5568- CONTRACTOR EMAIL: jpapernik@cityplumbing.org CONTRACTOR LICENSE #(REQUIRED): CITYPI`955KJ CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 052291 PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Joe Papernik CONTACT PHONE:360-661-5568 CONTACT EMAIL:jpapernik@cityplumbing.org BUILDING INFORMATION Existing Use of Building: commercial Contract Price of Work: $ 18,500 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure Typeof Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Cha a of Use DESCRIPTION OF WORK: Addition of toilet and lavatory for ADA restroom, Break room sink, two exam room sinks, and install hot water recirc pump on existing water heater. ASSOCIATED BUILDING PERMIT # if ap licabie : MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION F;rtury Count List of Fixtures Frxtum count Gst of Fixtures Fixture Count List of Fixtures Ffxture Count List of Fixtures A/C — Air Handling Units Gas Piping Backflow Preventer (Inside Bldg) Shower, Tub, or Combo Boiler Gas Range Clothes Washer Sink -Commercial (3comp,prep,Floor) Clothes Dryer Heat Pump&Ductless Dishwasher 4 Sink -Residential (kitchen, bath, bar) Duct System (Remodel) Refrigeration Drinking Fountain Sink -Utility, laundry, mop Exhaust Fans (Residential) Commercial Ventilatio., (Not Heat/AC system) Floor Drain 11Toilet Exhaust Hood (Type 1) Hose Bibb Urinal Exhaust Hood (Type 11) Water Heater Interceptor -Grease Waste/Water Piping Repair Exhaust Hood (Residential) Wood Stove Interceptor-Sand/Oil Water Service (behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/insert/Log Roof Drains Water Heater SPRINKLER 1 SUPPRESSION SYSTEM Sewage Ejector or Sump Pump 1 Other: hot water recirculation pump 'Wafer 7uppression System IN67TReads Chemical uppression System I No. of Heads ACKNOWLEDGEMENT 1 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 permed 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 1 am authorized by the owner of this property to perform the work for which application is made, and i comply with,toe to Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PER�p -� Owne5Kuthorized Agent Signature 7Date (Revised 10/10/2018