10200 19TH AVE SE COSTCO HEARING CENTER 2022-01-21

NMI PERMIT APPLICATION az BUILDIN / 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:1 0200 19th Ave. SE, Everett, WA 98208 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Costco Wholesale TENANT BUSINESS NAME(Commercial): Costco Wholesale OWNER MAILING ADDRESS: sTREET999 Lake Drive cm( Issaquah STATE WA ZIP 98027 OWNER PHONE:425-313-8100 OWNER EMAIL:garrettwatson@costco.com CONTRACTOR NAME:Iflterstate Construction Group Inc. CONTRACTOR ADDRESS: sTREET437 - 29th Street NE, Suite F Cm( Puyallup STATE WA ZIP 98372 CONTRACTOR PHONE:425-890-6358 CONTRACTOR EMAIL:larry interstateconstructiongroup.cone CONTRACTOR LICENSE#(REQUIRED):INTERCG974QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 51 597 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-890-6358 Larry Prescott CONTACT EMAIL:Iarry@interstatec ctiOngroup.com /BUILDING INFORMATION ✓ Existing Use of Building: Contract Price of Work:$62,110.00 Proposed Use of Building:Hearing Center Upgrade Heat Source: OGas ❑Electric' ❑Other NA BUILDING USE: ❑SFR ❑Townhouse Duplex ❑ADU Multi-Family-#Units: ` i❑ ❑ % Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑✓Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Relocate existing hearing booths and add one new booth. Replace existing cabinets with new. 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 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 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.I am 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 th tate Contra tors Law 18.27 RCW and 298. WAC. City of Everett Official Use Only 27/19 PERT \ °AOCt 03et ner/Auth ' Agent Signature e (Revised 10/10/2018) 1/