1700 13TH ST 2020-08-28 - Laserfiche WebLink

PERMIT APPLICATIOI BUILDING 1ECHANICAL / PLUMBING / SIGN . _?RINKLER / DEMOLITION EVERETTCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRES : - • - ' 21 (PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision \1 U 0 I�`I> �- Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Providence Health&Services-WA TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1321 Colby Ave cr-v Everett STATE WA zip 98021 OWNER PHONE: 425.261.4563 OWNER EMAIL:iames.grafton@providence.org CONTRACTOR NAME:McKinstry Co. LLC CONTRACTOR ADDRESS: STREET 5005 3rd Ave S CITY Seattle STATE WA ZIP 98134 CONTRACTOR PHONE:206.762.3311 CONTRACTOR EMAIL:audiew@mckinstry.com CONTRACTOR LICENSE#(REQUIRED):MCKINCL942DN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 049226 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206.930.0436 Audie Wallace CONTACT EMAIL:audiew@mckinstry.com BUILDING INFORMATION Existing Use of Building:Healthcare Contract Price of Work: $364,022 Proposed Use of Building:Healthcare Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Medical gas and plumbing serving 12 pre-operation rooms and 3 operation rooms. ASSOCIATED BUILDING PERMIT#(if applicable): X31.094 036 1 4 t; - if 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 A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer 14 Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) 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: 54 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.I am 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 PERI Owner/Authorized Agent Signature Date (Revised 10/10/2018)