1321 COLBY AVE 2ND FLOOR 2022-01-26

PERMIT APPLICATIONk BUILDIN&ECHANICAL / PLUMBING / SIGNIMPRINKLER / DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps(raeverettwa.aov f www.everettwa.aov/permits (Blw or Black Ink Only Plsaw) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1321 Colby Ave PROPERTY TAX #: 00438524600000 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Providence Health and Services TENANT BUSINESS NAME (Commercial): OWNER MAILING ADDRESS: STREET 1321 Colby Ave CITY Everett STATE WAII ZIP 98201 OWNER PHONE: Chris Britton OWNER EMAIL:Christopher.britton@providence.org CONTRACTOR NAME: Harris Company CONTRACTOR ADDRESS: STREET 3436 Airport Dr CITY Bellingham STATE WA zIP 98226 CONTRACTOR PHONE:360-305-7519 CONTRACTOR EMAJL:darobbins@harriscompany.com CONTRACTOR LICENSE #(REQUIRED): HARRIPN813JP CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 58454 PRIMARY CONTACT: ❑ OWNER I] CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Dirk Robbins CONTACT PHONE: 360-305-7519 CONTACT EMAIL:darobbins@harriscompany.com BUILDING INFORMATION Existing Use of Building: Medical Contract Price of Work: $ 20 000 Proposed Use of Building: Same Heat Source: OGas IDElectric DOther BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial (]Accessory Structure Type of Project: ZNew ❑Addition ❑Remodel ❑Re air FIT. I. ❑Sign ❑Sprinkler ❑Demofition LIChan e of Use DESCRIPTION OF WORK: NEW GREENHECK EF (SEE APPROVED SUBMITTAL), ALL DUCTWORK AND REGISTERS PER PLAN; ALL PLUMBING PER PLAN OR ASSOCIATED WITH PROJECT; AIR BALANCE CONFIRMATION; ALL ROOF- ING, ALL CORING THROUGH ROOF, ALL CLEAN UP. EXCLUDES ELECTRICAL AND CONTROLS. ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Count List of Fixtures F"""' count List of Fixtures Fixture Count List of Fixtures Fixture 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 1 Exhaust Fans (Residential) Commercial Ventilatior (Not Heat/AC system) Floor Drain Toilet Exhaust Hood (Type 1) 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 I 10ther: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log I I Roof Drains Water Heater SPRINKLER / SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System I INo- of Heads Chemical Suppression System I ANo. of Heads ACKNOWLEDGEMENT: I have reviewed this application and confirm the infomtation 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 BuiUng 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 Orty - Q PERMIT # --- nmer/Authorized Agent Signature Oate (Revised 16Y10I2018) 1/ Z