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<br />61Jl�D1NCIMECIH�,i�lC�►�IPI.UMBIN�lSlGNI�PRINK�ERIDEMt�LITIC3i�
<br />CITY OF EVERET7 P�F�iVI(T SERVI�ES
<br />3200 Cedar Si., E��ere;t, WA 98201 425-257-8810 FAX 425-257-8$57 v�+rw.everettwa.org
<br />APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM
<br />E ADDRESS: PRpAERTY TAX t4 PERMIT #
<br />3q27 Rucker� Ave. G0411300�013G0 �� ��� Z��^
<br />for new construction: Short PlaVsubd�vision
<br />OwNER The EVerett Clinic
<br />n�adress 3�101 �lovt Ave.
<br />ICAN7: ,_...... Owner __,_ Owner's A,ent
<br />coNrRacTOR —ne Everett Cliric
<br />Contractor
<br />_.. .. __....-,---_-----,�ot No.__.___ (attacn copy af long legal description}
<br />?none;'c-mail �I=�-GS�I-I ��
<br />e��vrstat�rz�� Everett, WA q8201
<br />�iUf12i dC[Of 5 li�P.f1t ._.,...... �f�itall �u�,' I�rc � ra ai !ehe.r ot r,n'.��„U !wm tr�o u•�vne� to da ware .r :r*especvl
<br />�& � �ia � Bui'.ding C�.uner-N/A COE F3us. ��c. #
<br />��i�i��ss 3°�01 Noyt Ave. E:veret�, WA q8201 �-�n��,ert��<,�i 425-25q-11�2
<br />TENANT BUSiNESS NAIkiE CONTACi FOFt PERINlT
<br />The Everett Clinlc _����I��� Scott Lawson
<br />ar,c�,Q,�_m;�,i =-5-25q-i1�2 slau�son�ev�rettclinic.com
<br />SUtLDiNG PERMIT APPL.ICATION coraTRacr PR�c� oF woRK �75�, GC0.00__ ____ ___
<br />__
<br />ExistingUsevfF3uiiding�ediGG�_!�f�IG2 BUIIdIYI�_ _ _ NEATSOURCE:
<br />_ _.
<br />Proposed Use of Build:ng_M�d,IGQI �'i=f IGe �Ulldln0
<br />------------- -"-- , .._._.. _... GaS__%�__ Electnc____ Other_�_
<br />Eiuiiding type: _._._ Single Fam�;Y __ ,. Dupiex _._.._Townh�use ._..__... Muiti-Family _i_. Commercia!
<br />Type of �ro;ect: New ,._ Addit�on _,__. Remodel ___ Repair _,X_ T.l. ,,, _ Siqn _.._....Sprinkier ......_.Demolition,___Change oi Use
<br />DESCRIPiION OF WQRK {add;t�on�t;p�ce providec�an theba�k}:
<br />TV-E ?ROJECT CONSISTS Of MINOR ALTERATIONS TO AN EXISTING MEDICAL CLIVIC. NO EXTERIOR WGRK.
<br />TI-E WORK WIL�� TA<E PLFCE IN A SPIALL PORTION OF THE SEGOKD FLCOR GLINICAL AREA AND NQUDES TNE REf'iOCELiNG OF EXISTING O�FiCS TO EXAM ROOP15 AND A
<br />SNARED WORK AREA. N=W WGRK TG IKGLJ7E IVFIL_ -1T EXISTING PPR-ITIONS, MSTCLLPTION CF NEN CPBINE?RY AVD Fi�i5NE5. MODiFICAT10�5 TO ELECTRIGPL,
<br />MECNANICPL, �LUI'iB�NG SYST°P95, F��4E PQ�TECT!ON 4VD FIR°-L�FE SFFETY SYSTEf'S AS R�OLIRED EY 4=W nCRK.
<br />HLECTRIC-1L, I"ECNA�IC.1L PLJM6 NG 6.�G F RE �ROTECT 0�� ��v F RE-L��FE SLF:TY SYSTEf'i5 TO BE B�DDE< GESIG�EC, BY GEF=RRED SUBI'91—T-1L.
<br />MECHANIGAL P�Rt�11T APPLICATIfJN PLUMBING PERMfT APPLICATION
<br />Type of Project: _„__ New „__Addn _, Alteration __,, Repair
<br />Show Number (#) ol fr.rtures
<br />} A,�C - air handling units
<br />Forced air systems
<br />Gas pipinc�
<br />Water �heater
<br />�as firepiace
<br />6as range
<br />� Ciothes dryEr
<br />Range hood
<br />Extiaust fnn
<br />H�at oump
<br />i Un'��t tie�ter
<br />i Ej4';sr
<br />� Rufnqert;cn
<br />? Uther
<br />__. _ . . ........___. . _
<br />SPRINKLER / St1PPP:ESSIQN SYSTEM
<br />Number of Heads
<br />of Project: _ __New _._.Addn __,_Alteration _..._,Repair
<br />Show Number (#) of fixtures
<br />Toilet
<br />BathtuG>
<br />Lavatory (wash hasin)
<br />! Shower
<br />Kitchen sink & dispcsai
<br />Oishwasher
<br />( Clothes washer
<br /># Water heater
<br />S!nk (s�:ruice/bar,+moaletc.)
<br />Ur��naf
<br />Dr'nk:nc� Fountair
<br />Flour dra+n
<br />Gre�se iran
<br />h,A�dica! G�s
<br />Other:
<br />Other:
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<br />n,Y�i ws� F e�r' d�ftF� nn r�nt 7 r a� nr �� int pruswrn¢ lu ywe �+ot�� t/ tc� ��'�.� a '.. c+ ar .a�on o- a,y other s�tte nr rr. i ntia re� it r� ... i��s ru�:.tmn
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<br />Owner orized Ac�ent �icn�t C)a?c (fdr.�ui�,ei9 G'2G`t2)
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