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

4-17 PERMIT APPLICATIO BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (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) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1700 13th St Everett, WA 98201 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Providence Regional Medical Center TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 10230 NE Points Drive cr' Seattle STATE WA ZIP 98033 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Burns Fire Protection Systems, Inc. CONTRACTOR ADDRESS: STREET P.O. Box 1110 CITY Granite Falls STATE WA ZIP 98252 CONTRACTOR PHONE: 425-388-0124 CONTRACTOR EMAIL: Adminasst@burnsfire.com CONTRACTOR LICENSE#(REQUIRED): BURNSFP841 DU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054660 PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-905-5780 Keith Kyle CONTACT EMAIL: Keith@burnsfire.Com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ 20250.00 Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel El Repair ❑T.I. ❑Sign VSprinkler ❑Demolition ❑Change of Use DESCRIP ORK: Level Phase 2 - Burns to modify sprinkler system to existing tower D Wing Level 2, to conform with new ceiling plan. ASSOC! ILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project: New _Addn _Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures _A/C—Air Handling Units •Heat Pump Toilet _Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub _ Urinal Gas Piping Boiler Lavatory(Wash Basin) _ Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal _ Grease Trap Gas Range Ducting Dishwasher Roof Drains _Clothes Dryer Hookups Other: Clothes Washer _ Medical Gas •Range Hood Water Heater Other: _Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPP• SSION S STEM Chemical or Water ) IN•,. of Heads ACKNOWLEDGEMENT:I have reviewer'his application:end 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 g:.,ting of a p.--mit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under - -6umstance.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 7 Z 6 / PERMIT 1- l 0,1 l J Us1L w erT uthorized Agagi Signature Dat (Revised 9/23/2016)