2930 MAPLE ST KAISER PERMANENTE 2021-11-15

4344' PERMIT APPLIC ,TION a. 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:2930 Maple Street PROPERTY TAX#:00439069505800 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION ,r. OWNER NAME: Kaiser Permanente TENANT BUSINESS NAME(Commercial): Kaiser Permanente OWNER MAILING ADDRESS: sTREET2930 Maple Street CITY Everett STATE WA ZIP 98201 OWNER PHONE: 206-427-9858 OWNER EMAIL:nigel.s.horton@kp.org CONTRACTOR NAME:Mortenson CONTRACTOR ADDRESS: STREET10230 NE Points Drive, Suite 300 cny Kirkland STATE WA zip 98033 CONTRACTOR PHONE:425-497-7092 CONTRACTOR EMAIL:holly.shoubridge@mortenson.com CONTRACTOR LICENSE#(REQUIRED):MAM ORC 190N6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 021465 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑✓ OTHER(Please Specify) Envelope Consultant/Architect CONTACT NAME: CONTACT PHONE:253-625-7090 Todd J. Wolf CONTACT EMAIL:twolf@nexusbec.com BUILDING INFORMATION Existing Use of Building:Medical Center Contract Price of Work:$496,951 Proposed Use of Building:No Change - Medical Center Heat Source: ©Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install new single-ply membrane roof over existing asphalt roof assembly. ,Vo el-R.teEri ✓r op (() -isetarn/. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION s. PLUMBING PERMIT APPLICATION ,, Fixture Fbctrne Fixture Fixture Count List of Fixtures court 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 Ventilation 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 No.of Heads Chemical Suppression System I 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.lam 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 Only raft. idi ,i, PERMI .. ..,, . pli/Av.., T 20(57_.czs—' Own A thori -d Agent Si,nature Date (Revised 10/10/2018)