1700 13TH ST 9TH FLOOR 2022-01-20

PERMIT APPLICATIO0 BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 OL (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1700 - 13th St., Everett, WA 98201 PROPERTY TAX #: 00438524702102 LEGAL for new construction: Short Plat subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Providence Health and Services - Washington TENANT BUSINESS NAME (Commercial): Providence Regional Medical Center Everett OWNER MAILING ADDRESS: STREET 1321 Colby Ave tiny Everett STATE WA zip 98201 OWNER PHONE: 425-261-4563 OWNER EMAIL:james.grafton@providence.org CONTRACTOR NAME: Mortenson Construction CONTRACTOR ADDRESS: STREET 10230 NE Points Dr. CITY Kirkland STATE WA ZIP 98033 CONTRACTOR PHONE: 425-497-7092 CONTRACTOR EMAIL: holly.shoubridge@mortenson.com CONTRACTOR LICENSE #(REQUIRED): MAMORC"190N6 CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 021465 PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Holly Shoubridge CONTACT PHONE: 425-497-7092 CONTACT EMAIL: holly.shoubridge@mortenson.com BUILDING INFORMATION Existing Use of Building: hospital (unfinished warm shell) Contract Price of Work: $ 21,192,000 Proposed Use of Building: hospital Heat Source: OGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ZCommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑✓ T.I. []Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Construction of 64 patient rooms and support space as tenant improvement in existing warm shell. warm shell. ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Count List of Fixtures Fixture 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 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 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 No. of Heads Chemical Suppression System No. of Heads ACKNOWLEDGEMENT: l 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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT # (Revised 1011012018)