2520 MADISON ST SUNRISE CONVALESCENT CENTER 2025-08-08

MAS PERMIT APPLICATIO— NS BUILDIN( MECHANICAL / PLUMBING / SIGN I 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:2520 Madison St PROPERTY TAX#:28050800200100 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Sunrise View Retire Villa, Inc. TENANT BUSINESS NAME(Commercial): Sunrise View Center OWNER MAILING ADDRESS: STREET 2520 Madison St. CITY Everett STATE WA ZIP 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Commercial Fire Protection, Inc. CONTRACTOR ADDRESS: STREET 17199 Bennett Rd. CITY Mount Vernon STATE WA ZIP 98273 CONTRACTOR PHONE:360 848-9093 EXT 113 CONTRACTOR EMAIL:delta@cfirepro.com CONTRACTOR LICENSE#(REQUIRED):COMMEFP1 32MM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 34661 PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE:360 848-9093 EXT 113 Della Dellinger CONTACT EMAIL:delta@cfirepro.com BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $2,511.00 Proposed Use of Building: Heat Source: ElGas ElElectric ElOther BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-# Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑✓Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Add 3 sprinkler heads ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture List of Fixtures List of Fixtures Count List of Fixtures Count List of Fixtures Count Count 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 Ventilation 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 3 INo.of Heads Chemical Suppression System 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, an mply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only e ' � PER l l 0 � (90� 0 er thorized gent Signature / • Date (Revised 10/10/2018)