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MI PERMIT APPLICATION M BUILDING . .MECHANICAL / PLUMBING / SIGN I L. 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 I www.everettwa.gov/permits (Blue or Black Ink Only Please) 7-zoo t7✓(fir Si PROJECT SITE INFORMATION PROJECT SITE ADDRESS:eve-, Everett WA 98021 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Providence Health & Services -WA TENANT BUSINESS NAME(Commercial):..,)-Wti, 1.44,„,( 2, OWNER MAILING ADDRESS: STREET 1321 Colby Ave &Cy cin. Everett STATE WA ZIP 8021 OWNER PHONE: 425.261.4563 OWNER EMAIL:james.grafton@providence.org CONTRACTOR NAME:McKinstry Co LLC CONTRACTOR ADDRESS: STREET 5005 3rd Ave S ) cin, Seattle K---ATE WA 98134 CONTRACTOR PHONE:206.762.3311 CONTRACTOR EMAIL:audiew@mckinstry.com CONTRACTOR LICENSE#(REQUIRED):MCKINCL942Dr ,, CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 049226 PRIMARY CONTACT: E OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) ted,. CONTACT NAME: CONTACT PHONE:206.930.0436 ,„,...--°*'- Audie WallaceCONTACT EMAIL:audiew@mckinstry.com BUILDING INFORMATION Existing Use of Building:Healthcare Contract Price of Work: $371,292 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: Mechanical Space; Provide and install (4) new terminal units and associated supply/exhaust ductwork for shelled 12 pre-op patient rooms, nurse stations, and (3) OR suites. The new HVAC ductwork distribution is connecting onto existing building central HVAC equipment ASSOCIATED BUILDING PERMIT#(if applicable): 81904-036 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 l,1 Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) 2 Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation 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: i`, Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log 4 Air Terminal Un.`' Roof Drains Water Heater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump i Other: _he Ili a4(,I;.1 2_ 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 compl with the State Contractors Law 18.27 RCW and 296.200A WAC. j.� City of Everett Official Use Only \ `� ell P RMI.T# ';\ °C) 7/2-4 et' ccL dao Owner/Authorized Age t Signature Date (Revise 0/10/2018)