Laserfiche WebLink
• I • <br /> • <br /> PERMIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# 1# J T /�� <br /> 1321 Colby Avenue, Everett,WA 98201-1665 00438524600000 PE 1R TGJ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) X� <br /> OWNER PROVIDENCE HEALTH&SERVICES WASHING'Phone/E-mail <br /> Address 1801 LIND AVE SW#9016, City/State/Zip RENTON,WA 98057 <br /> APPLICANT: Owner _Owner's Agent x Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Fire Sprinklers Inc. L&I Lic.# FIRESI*988RJ COE Bus.Lic.# 47539 <br /> Address 1524 45th Ave E, Suite 102, Sumner, WA 98390 Phone/Email olegs@firesprinklersinc.com <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> CHC South Everett Dental Clinic Phone/E-mail 253-826-0099/olegs@firesprinklersinc.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $22,277 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family x Commercial <br /> Type of project: New Addition Remodel Repair T.I. x Sign x Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ADD AND RELOCATE SPRINKLERS AS REQUIRED FOR NEW WALLS AND CEILINGS.. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn X Alteration_Repair Type of Project: New Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems 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 /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> 110 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 complied <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 /> f2 - <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br />