2930 MAPLE ST KAISER PERMANENTE 2020-12-31

PERMIT APPLICATIO ,BUILDIN ECHANICAL / PLUMBING / SIGN PRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES r'7 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): EVM EVERETT OWNER MAILING ADDRESS: STREET 12501 EAST MARGINAL WAY SOUTH crry TUKWILA STATE WA ZIP 98201 OWNER PHONE: N/A OWNER EMAIL: N/A CONTRACTOR NAME MACDONALD MILLER FACILITY SOLUTIONS CONTRACTOR ADDRESS: STREET 7717 DETROIT AVE SW cry 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 ❑ 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: $ 20,000 Proposed Use of Building: MEDICAL CENTER Heat Source: ❑Gas iZiElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: VCommercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 7y L--i tcy-i.._., d. Install (2) 120 gallon water heater and (1 ) expansion tank, per0-r1. ASSOCIATED BUILDING PERMIT#(if applicable): �11 tivti(4)V.- MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn Alteration Repair Type of Project: New Addn I Alteration Repair #of #of List of Fixtures 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 Other: Clothes Washer Medical Gas Range Hood 2 Water Heater 1 Other: Expansion tank Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water 1 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 m and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. / City of Everett Official Use Only PERMIT# . 1 0/15/201 9 Owner/Authorized Agent Signature Date (Revised 9/23/2016)