2026 E GRAND AVE NURSING EVOLUTIONS 2022-05-13

• PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (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:2026 E. GRAND AVE PROPERTY TAX#:00563240702900 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 198TH ST ASSOCIATES LLC TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: srREET2026 E. GRAND AVE clrY EVERETT STATE WA ZIP 98201 OWNER PHONE: 425-345-9003 OWNER EMAIL:TODDPOHLAND@GMAIL.COM CONTRACTOR NAME:ROBINSON PLUMBING INC CONTRACTOR ADDRESS: sTREET29330 124TH AVE NE Cm. ARLINGTON STATE WA ZIP 98223 CONTRACTOR PHONE:360-403-7462 CONTRACTOR EMAIL:ROBINSONPLUMBINGINC@GMAIL.COM CONTRACTOR LICENSE#(REQUIRED):ROBINP*272C2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 008098 PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-508-3459 KEN ROBINSON-ELMSLIE CONTACT EMAIL:ROBINSONPLUMBIGNINC@GMAIL.COM BUILDING INFORMATION Existing Use of Building:SFR Contract Price of Work:$ 12,500.00 Proposed Use of Building:SFR Heat Source: OGas ❑Electric ❑Other BUILDING USE: IZJSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ✓❑Remodel II Repair DTI. ❑Sign ©Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: RETRO-FIT FIRE SPRINKLER SYSTEM IN EXISTING SFR WITH 25 HEADS, 1 BACKFLOW ASSEMBLY AND 1 RISER PER NFPA 13D. 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 NC—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 Ventilatior 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 I' b 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.1 am the owner,or 1 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 PER I (124S3.4 Owner/Authorized Agent Signature Date (Revised 10/10/2018) _ i