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PERMIT APPLICATION <br /> /1 IBUILDINGAECHANICAL I PLUMBING /SIGN •IRiNKLER I DEMOLITION <br /> i�', A_ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa. ov/ ermits <br /> g p <br /> (Blue or Black Ink Only Please) : PROJECT SITE INFORMATION..: •. .. <br /> PROJECT SITE ADDRESS:900 Pacific Ave, Everett,WA 98201 PROPERTY TAX#:29053000200300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal desorption) <br /> CONTACT INFORINATION <br /> OWNER NAME: PROVIDENCE HEALTH&SERVICES-WASHINGTON TENANT NAME(If Commercial): PROVIDENCE HEALTH <br /> OWNER MAILING ADDRESS: STREET 1801 Lind Ave SW, <br /> CITY Renton, STATE WA zip 98057 <br /> OWNER PHONE:(425)525-3355 OWNER EMAIL: <br /> CONTRACTOR NAME: Patriot Fire Protection, Inc. <br /> CONTRACTOR ADDRESS: STREET 2707 70th Ave E <br /> cny Tacoma STATE WA zip 98424 <br /> CONTRACTOR PHONE: 253-926-2290 CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): PATRI FP099CF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 024694 <br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR ❑OTHER(Please Specify) • <br /> CONTACT NAME: CONTACT PHONE:(253)926-2290 • <br /> Jared He it CONTACT EMAIL:jared.heit@patriottire.corn <br /> • BUILDING PERNlIT APPLICATION. <br /> Existing Use of Building:Medical Contract Price of Work:$2,667 <br /> Proposed Use of Building:Same Heat Source: ❑Gas El Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: INCommercial ©lndustriai <br /> Type of Project: New ❑Addition ❑Remodel ❑Repair BT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ADD/RELOCATE FIRE SPRINKLERS FOR T.I. WALLS & CEILINGS. PATRIFP499CF. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): i32 0 1 1 0 I—7 <br /> MECHANICAL PERMIT APPLICATION: PLUMBING PERMIT APPLICATION, <br /> Type of Project: QNew 0 Addn CIAlterafion 1E0tepair Type of Project: New EAddn QAlteration EIRepair <br /> Fr tares List of Fixtures Fixtures List of Fixtures List of Fixtures Fixtures List of Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood _Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM. <br /> s Number of Heads To <br /> ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance.lam the owner,or l am authorized by the owner of this property to perform the work for which application is made, <br /> and f comply with the State Contractors Law 18.27 RCW and 2196.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# n\ <br /> 03/01/2021 10-103 — Vo3 <br /> Own Authorized Agent Signature V Date (Revised 5/20/2016) <br /> /� <br />