4310 COLBY AVE COLBY MEDICAL CENTER 2022-01-20

PERMIT APPLICATION BUILDIN MECHANICAL/PLUMBING /SIG PRINKL ■ ��;;,� ■ / L.0 EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 AUG 2 6 2020 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 PUBLIC WORKS - PROJECT SITE ADDRESS:4310 Colby Ave PROPERTY TAX#:00582202600200 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: MATANA LLC TENANT BUSINESS NAME(Commercial): Colby Medical Center OWNER MAILING ADDRESS: STREET 117 E. Louisa Suite 230 cm, Seattle STATE WA zip 98102 OWNER PHONE:206-972-7070 OWNER EMAIL:christian.decker@seattleretail.net CONTRACTOR NAME:Sign-Tech Electric CONTRACTOR ADDRESS: sTREET5009 Pacific Hwy E #11 cry Fife STATE WA zip 98424 CONTRACTOR PHONE:253-922-2146 CONTRACTOR EMAIL:ashleyc@signtechelectric.com CONTRACTOR LICENSE#(REQUIRED):SIGNTEL988BG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 034625 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-922-2146 Ashley CONTACT EMAIL:ashleyc@signtechelectric.com BUILDING INFORMATION Existing Use of Building:Multi Tenant Medical Building Contract Price of Work:$3 '; 00 3000 Proposed Use of Building:Multi Tenant Medical Building Heat Source: ❑Gas 17 Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU OMulti-Family-#Units: ❑✓Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install one non-illuminated single sided freestanding sign onto existing cement base.4'h x 6'w x 5.5"d 24 square feet total 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 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 pennit 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 lam 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 Ovine AuthorPz rent vW nature Date (Revised 1 t 0/2018)