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�1® <br />EVERETT <br />PERMIT APPLICATION <br />BUILDING I MECHANICAL I PLUMBING / SIGN I SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />!P1425-257-8810 1 FAX 425-257-8857 1 (E) everetteos0everettwa.gov I www.everedm.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 916 PACIFIC AVE. <br />PROPERTY TAX #:29053000200100 <br />LEGAL for new construction: Short Plat/subdivision Sec6m3OTo^*sl*29Rar9eosou.uN=aMv Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: PROVIDENCE HEALTH & SERVICES-WASHINGTON TENANT BUSINESS NAME (Commercial): PROVIDENCE REGIONAL MEDICAL CENTER <br />OWNER MAILING ADDRESS: STREET 1801 LIND AVE SW #9016 <br />cnv RENTON STATE WA z,P 98057 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: THE SIGN POST <br />CONTRACTOR ADDRESS: STREET2019 E. BAKERVIEW RD. <br />C,Ty BELLINGHAM STATE WA ZIP 98226 <br />CONTRACTOR PHONE: 360-671-1343 <br />CONTRACTOR EMAIL: BRENNA@THE-SIGNPOST.COM <br />CONTRACTOR LICENSE #(REQUIRED): SIGNPI*065MM <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 051261 <br />PRIMARY CONTACT: ❑ OWNER ❑� CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />LORIE BLUNT <br />CONTACT PHONE: 360-671-1343 <br />CONTACT EMAIL: LORIE@THE-SiGNPOST.COM <br />BUILDING INFORMATION <br />Existing Use of Building: MEDICAL CENTER lContract <br />Price of Work: $ 50,954 <br />Proposed Use of Building: PROVIDENCE REGIONAL MEDICAL CENTER Heat <br />Source: ❑Gas ❑Electric []Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑✓ Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. ❑✓ Sign ❑S rinkler ❑Demolition ❑Chan a of Use <br />DESCRIPTION OF WORK: REBRANDING - REPLACING EXISTING SIGNS LIKE FOR LIKE: 83)DIRECTIONAL PARKING SIGNS <br />(2) NON -ILLUMINATED WALL SIGNS, (8) DIRECTORY SIGNS -FACE REPLACEMENT & LED RETROFIT <br />INSTALLING (6) LED RETROFIT IN EXISTING DIRECTORY MONUMENT SIGNS <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shover, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen,bath,bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not HeaVAC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Cif <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />1 <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />I No. of Heads <br />Chemical Suppression System <br />INo. of Heads <br />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 <br />current federal, state, and kocal law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />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, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Brenna McGarry 04-27-21 <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT <br />Zt CA �Z <br />(Revised lWiO12018) <br />