2930 MAPLE ST KAISER PERMANENTE 2020-12-31

4ren. PERMIT APPLICATI BUILDIN / MECHANICAL / PLUMBING / SIGGSPRINKLER/ 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 ST, EVERETT, WA 98201 PROPERTY TAX#: 00439069505800 LEGAL for new construction: Short Plat/subdivision SEE ATTACHMENT Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: KAISER PERMANENTE TENANT NAME (If Commercial): KP EVM PHARMACY OWNER MAILING ADDRESS: STREET 521 WALL ST cITY SEATTLE STATE WA ZIP 98121 OWNER PHONE: N/A OWNER EMAIL: N/A CONTRACTOR NAME: MACDONALD MILLER FACILITY SOLUTIONS CONTRACTOR ADDRESS: STREET 7717 DETROIT AVE SW CITY SEATTLE STATE WA ZIP 98106 CONTRACTOR PHONE: (206) 768-4062 CONTRACTOR EMAIL: permits@macmiller.com CONTRACTOR LICENSE#(REQUIRED): MACDOFS980RU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 040665 PRIMARY CONTACT: ❑ OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (206) 768-4062 AMMONE BEMBRY CONTACT EMAIL: permits@macmiller.com BUILDING PERMIT APPLICATION Existing Use of Building: MEDICAL CENTER Contract Price of Work: $ 17,500(MECHANCIAL:$12,500/PLUMBING:$5,000) Proposed Use of Building: MEDICAL CENTER Heat Source: ❑Gas IZElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: CuGommercial Industrial Type of Project: ONew DAddition ERemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition CI Change of Use DESCRIPTION OF WORK: See attachment. ASSOCIATED BUILDING 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 #of 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 3 Other: Diffusers Clothes Washer Medical Gas Range Hood Water Heater 1 Other:SS sink with eyewash station Exhaust Fan 1 Sink(Service/Bar/Mop/etc.) 1 Other: Mixing Valve(Asse1071) SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water I No. of Heads ACKNOWLEDGEMENT:1 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 pFDLAIT 04/08/2020 20�`1 V C (, Owner/Authorized Agent Signature Date (Re ised 9/23/2016)