1321 COLBY AVE 4TH FLOOR 2022-04-27

PERMIT APPLICATION. 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 I l k It*Only Phrase) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1321 Colby Ave PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Providence Health&Services TENANT BUSINESS NAME(Commercial): PRMCE OWNER MAILING ADDRESS: STREET 1700 13th St ciTY Everett STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Burns Fire Protection Systems, Inc. CONTRACTOR ADDRESS: STREET PO Box 1110 CITY Granite Falls STATE WA ZIP 98252 CONTRACTOR PHONE:360-691-2235 CONTRACTOR EMAIL:audra@burnsfire.com CONTRACTOR LICENSE#(REQUIRED):BURNSFP841 DU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054660 PRIMARY CONTACT: ❑OWNER D CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-905-5780 Keith Kyle CONTACT EMAIL:keith@burnsfire.com BUILDING INFORMATION Existing Use of Building:Part of the Hospital •Contract Price of Work:$10,000.00 Proposed Use of Building:Hospital Heat Source: OGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ElAccessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ©T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Burns to modify existing wet sprinkler system to add 8 pendants heads as required in new CT room 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/SUPPR ESSION SYSTEM ! Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System I 'g 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 the State Contractors Law 18.27 CW and 296.200A WAC. City of Everett Official Use Only PERMIT# KZ,b� J d 03-12-2021 Owner/Authorized Agent Signatur Date (Revised 10/10/2018)