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� ' �ERMIT APPLICATIC <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/��MOLITION <br /> CITY OF EVER�TT PERMIT SERViCES <br /> 3200 Cedar Sl., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.or�g( <br />� � � PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �-I�-i�-I U <br /> SITEADDRESS: � �y1 C,��fY AV UE PROPERTYTAXp See Attached P RMIT - <br /> �.. �� �. <br /> gee att hed <br /> LEGAL for ncw consiruclion� Short PlaVsubdrvision _D_2S_C_, Lol Nu.__ 1�IEicli ccDY o���ng Icgal desrnphon) <br /> Providence Regional Medical Center Everett <br /> OWNER �honclE�ma�� (425) 261-2000 <br /> ACdress 1321 Colby Avenue C�tylSt�nclZio Everett, WA 98206 <br /> APPLICANT: _ Q+.ner X_ 0•nnersAgunt _Contraclor ___ Contraqo'sAgent _ �enante*�siwrna.,nv�,oi�o�+,omnore+oo��maow:a„m��c,w� <br /> CONTRACTOR Mortenson Construction L 81 Lic. # 706, 089-QO-0 COE Bus L�c. # 021465 <br /> 10230 NE Points Drive q300, Kirkland, WA 98033 14z5) 459-U584 <br /> AUaress Phonc�Email melissa.teichman@mortenson.com <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> � Rick Ullman (206) 521-3510 <br /> S� �(� �r ann�c�e�ma�i rick.ullman@zgf . com <br /> BUILDING RMIT APPLICATION CONTRACT PRICE OF WORK $1, 135, 380 <br /> Ewsting Use of 8uilding HOSpltdl ____ HEAT SOURCE: <br /> Proposed Use of Building HOSPital __ Gas Electnc _ Other_ . <br /> Bwiding type: _Single Family ___Duplez_Townhouse _Muili-Family _Commercial <br /> Type of project: New Addition X Remodel Repair_T.I. _Sign__Sprinkler_Demolition_Ghange ol Use <br /> DESCRIPTION OF WORK(adAdional space pmviCed on rh�Gacti)t <br /> Build out shell spaces in surgery area to create one new finished 6 furnished suzgery <br /> operatinq room (E2183) , and two new finished operating rooms, but without <br /> equipment installed (E21P4 and F2185) , and create a new clean core room (E2186) <br /> with associated finiehes and e i ent. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projecl: _New_Adtln }{Alteratlon_Repalr 7ype ol ProJecl: _New_Addn X qlteratlon__Repali <br /> Show Number(#1 o!lixtures Show Number(p)ol firtures <br /> NC -air hanAling units Toilel �� <br /> Forced air systems Balhlub <br /> Gas piping Lavato (wash basm) <br /> ' Waler healer Shower <br /> i <br /> Gas freplace Kilchen sink 8 Ais{x�sal <br /> Gas r.nge "� Dishwasher <br /> Clothes d er Clolhes washer <br /> Ranga ha�d Wa�er heater <br /> Exhaust lan 6 oa scrud n�Ak� S�nk(scrvlcelbadmopletc. <br /> Heat pump BackOow prevenler <br /> UNI heater Urmal <br /> Botler Drinking Fountam <br /> Reingera�ion Floor drain <br /> � Woodslove Grease trep <br /> � Ducting Rool Arains <br /> Other ldedical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM oiner: <br /> Number ol Heads Other. <br /> 1�irmby cert+y tl�al l�avc rea0,ntl e�ammed Itns�VD'�'wtbn anC know Inc same lo bc We an0 conetl .11 provisa�s ol laws ar,d ord:nances covcrn:ng m,rype o7 wo�k w:ll h wmpl� <br /> w'�wne'ner;pecdied�ere�n or not.TAe gnnLn9 0l a permit Eoes nol presume Io grve auU�orRy to v�ol.ite or cancel l�e prov2on o�any other;ble or locril Cr.v regulning cnns W dan <br /> Thal I am:miner¢ed by Ine ownrr ol U�u O�o�etty lo pedorm tlm work br whkh applicauon rs made and I compN wi;n Ne Stale f,ontr.nclors Ww 18 27 RCW ana 29G 200A WAC. <br /> , <br /> � - I � �� �fz <br /> OwnerlAmhorized Agent SignaWre Date (Rrvised 6i?07?) <br />