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11 0 <br />• <br />work <br />CITY kit- EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett. WA 982 1 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICAT ]NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX # 1411300602200 004113001,00101, j I <br />3901 Noyt Ave. - [ � v 00431100600100 1 <br />LEGAL for new construction: Short Platisubdivision „Lat Na(attach copy of long legal description) <br />OWNER The Everett Clinic <br />PhonelE-mail 425-259-1162 <br />Address 3901 Not Ave, <br />Gtyistateizip Everett NA 98201 <br />APPLICANT: --Owner ­ Owner's Agent __ Contractor --Contractor's Agent --Tenant torus! provtaa a Ia aretwnsanurn n. me cwncr roar..-:. „ nu sna:e,7 <br />CONTRACTOR The Everett Clinic <br />L & I Lic. # Building Owner -N/A COE Bus. Lic. # <br />Address 3901 Noyt Ave. Everett NA 98201 <br />IlPhoneiEmaii 425-259-1162 <br />TENANT BUSINESS NAME <br />The Everett Clinic <br />CONTACT FOR PERMIT <br />Janet Monda <br />PhonerE-mail 425-823-2244 janet@ouwerks.com <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK $325,-00QwQ _ <br />Existing Use of Building rledical OO £Ice BuildirlG-j HEAT SOURCE: <br />Proposed Use of Building_MedI(; I _Office _Gas _.,.,._..,. Electric,_,-_,.. Other_.__.. <br />Building type: __.- Single Family ___ Duplex ___Townhouse ___ Multi -Family X_ Commercial <br />Type of project: _.._.... New ,.,.,..,.,, Addition . X. Remodel _-. _ Repair--- T.t. ___ Sign ......_S rinkler._.__..Demolition............Chan e of Use <br />DESCRIPTION OF WORK {additional space provided on the back): <br />THE PROJECT CONSISTS OF MINOR ALTERATIONS TO AN EXISTING MEDICAL CLINIC. NO EXTERN WORK. MODIFICATIONS OF INTERIORS TO <br />INCLUDE: REMOVAL OF NON -BEARING PARTITIONS 6 CASEWORK, NEW WORK TO INCLUDE: METAL STUD WALLS, NEW FLOORING AND CEILING IN <br />SOME AREAS. MODIFICATIONS TO ICAL MECH <br />t4BFl4. <br />ELECTRICAL, MECHANICAL, PLUMBING AND FIRE -LIFE SAFETY SYSTEMS TO BE BIDDER DESIGNED, BY DEFERRED SUBMITTAL. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: __New ___Adds --Alteration, <br />Show Number (#) of fixtures <br />Type of Project: _New ___Addn __Alteration _Repair <br />Show Number (# of fixtures <br />A/C - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin <br />Water htmter <br />! Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />l Exhaust fan <br />Sink service/barimo /eta <br />Heat pump <br />Backfiow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />( Woodstove <br />i Grease trap <br />Ducting <br />Roof drains <br />Other_ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other. <br />(umber of Heads <br />! Other: <br />I hereby cartify that i have rea id examined chi, apoiLcai<,n and know the same to be true and corrcc: ,. ;..eats of laws and ordinances governing this type of work wil€ bo compiicd <br />with whether specilao he - L The granting of a perr^.ii does not presume to give author ty In Ine orovision of any other state or focal law regulatatg ronstruct on <br />Th a ortr r of this tMoc > ' ..t ira�work for whir:h application is made ano i , -0, tine state Contractors Law 18.27 ReW and 296:200A t+rAC. <br />Owner uthorized Agent Slg a ure Date (P.erised 612012) <br />t[z <br />