3726 BROADWAY GATEWAY SURGICAL CENTER 2020-01-21

PERMIT APPLICATIO BUILDIN -CHANICAL/ PLUMBING /SIGN RINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 3726 Broadway PROPERTY TAX#: 00437392500001 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Western Wa. Medical Group TENANT BUSINESS NAME(Commercial): Gateway Center OWNER MAILING ADDRESS: STREET3726 Broadway, Suite 210 & 206 CITY Everett STATE Wa ZIP 98201 OWNER PHONE:425-374-5176 OWNER EMAIL:SULLIVAN@WWMEDICALGROUP.COM CONTRACTOR NAME: Morgan mechanical Inc. pal OO5 CONTRACTOR ADDRESS: STREET 12314 134th Ct NE CITY Redmond STATE Wa ZIP 98052 CONTRACTOR PHONE: 425-582-0472 CONTRACTOR EMAIL:jhughes@hvacmorgan.com CONTRACTOR LICENSE#(REQUIRED): MORGAM I883WT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 052553 PRIMARY CONTACT: 0 OWNER CI CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-228-9077 JOHN HUGHES CONTACT EMAIL:jhughes@hvacmorgan.com BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$8346.00 Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther BUILDING USE: ❑SFR ❑Townhouse ❑Duplex EADU ❑Multi-Family-#Units: E✓Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition E✓Remodel ❑Repair ❑✓T.I. ESign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: )C. l ' r v —t Sur) N 6- R BTU rr f 3 ct57 1 B1907-005 �C• 1 �� s ,1=w 1 MC, N � ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) 5 Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) 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!SUPPRESSION SYSTEM` Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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 I 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 18.27 RCW and 296.200A WAC. City of Everett Official Use Only t 6- C` 0--02 r — o Ow thorized Agent Signature Date (Revised 10/10/2018) L11