2930 MAPLE ST KAISER PERMANENTE 2020-12-31

4E77 i PERMIT APPLICATION. BUILDING / MECHANICAL I PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:2930 MAPLE STREET, EVERETT, WA 98201 PROPERTY TAX#:00439069505800 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: KAISER PERMANENTE (ATTN:Bryan Moorman) TENANT BUSINESS NAME(Commercial): KAISER PERMANENTE OWNER MAILING ADDRESS: STREET 1200 SW 27TH STREET CITY RENTON STATE WA ZIP 98057 OWNER PHONE: 206-419-4845 OWNER EMAIL:bryan.a.moorman@kp.org CONTRACTOR NAME:MORTENSON CONSTRUCTION (ATTN: Holly Shoubridge) CONTRACTOR ADDRESS: STREET 10230 NE POINTS DRIVE, SUITE 300 CITY KIRKLAND STATE WA ZIP 98033 CONTRACTOR PHONE:425-497-7092 CONTRACTOR EMAIL:holly.shoubridge@mortenson.com CONTRACTOR LICENSE#(REQUIRED):CC MAMORC*190N6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 021465 PRIMARY CONTACT: Cl OWNER ❑ CONTRACTOR El OTHER (Please Specify) ARCHITECT CONTACT NAME: CONTACT PHONE:206-957-1906 "Douglas McNutt CONTACT EMAIL:douglas.mcnutt@salus.archi BUILDING INFORMATION Existing Use of Building:MEDICAL OFFICE BUILDING Contract Price of Work: $'"""" HOC 000.00 Proposed Use of Building:MEDICAL OFFICE BUILDING Heat Source: OGas DElectric DOther BUILDING USE: ❑SFR Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ERepair ETA. ESign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Adding new walls to the existing pharmacy for new equipment layouts including a segregated compounding room, replacement of doors, adding security fixtures throughout the space, and finishes 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 A/C—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) 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: 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 �`%'�/�,��J� PERMIT# 1 2 \ _ 02—b ��'CJ 11-15-2019 ✓ — Owner/Authorized Agent Signature Date (Revised 10/10/2018) \n.