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t <br /> ERMIT APPLICATI00 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> 1-160 3fl-1 <br /> SITE ADDRESS:9 &Dr+�� Everett, WA 98201 PROPERTY TAX#290530002001001 PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Providence Everett Medical Center Phone/E-mail <br /> Address 916 Pacific Ave City/State/Zip Everett, WA 98201 <br /> APPLICANT:L Owner Owner's Agent ✓Contractor Contractor's Agent LTenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Hermanson Company State Lic.# HERMACLO05BJ City Bus. Lic.# 037262 <br /> Address 1221 2nd ave N Kent, WA 98032 Phone/Email206-200-7804 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Terese Anderson <br /> Phone/E-mail 206-200-7804 permits,@@hermanson.cl- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 80000.00 <br /> Existing Use of Building Hospital HEAT SOURCE: <br /> Proposed Use of Building Hospital Gas Electric-0 Othero <br /> Building type: DSingle Family a DuIexaTownhouse F]Multi-Family 1r l Commercial <br /> Type of project: New Addition Remodel Re air T.I. ✓ Sin S rinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Install (2) FCUs and ductwork modifications as shown on M4.35, 4.36, M5.35, M5.36 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project:LNewLjAddn LAItielraitilon epair Type of Project: NewaAddn DAlteration EIRepair <br /> Show Number # of fixtures Show Number # of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> 2 Otherfan coil units Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That 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. <br /> k12— <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />