1800 41ST ST EVERETT CLINIC FRONTIER BUILDING 2018-09-13

OIEETT PERMIT APPLICATION BUILDING/ MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (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: 1800 41St Street PROPERTY TAX#: 00620800000002 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 1800 41St Street LLC TENANT NAME(If Commercial): The Everett Clinic OWNER MAILING ADDRESS: STREET 1800 41st Street Ste 210 • CITY Everett _ STATE •'A ZIP 98203 OWNER PHONE:425-252-0139 OWNER EMAIL: Donald.Melum p@am.jll.com CONTRACTOR NAME: The Everett Clinic CONTRACTOR ADDRESS: STREET 3901 Hoyt Ave. CITY Everett STATE WA ZIP 98201 CONTRACTOR PHONE: 425-328-6825 CONTRACTOR EMAIL: MGriffith@everettclinic.com CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Mike Griffith CONTACT PHONE: 425-328-6825 CONTACT EMAIL: MGriffith@everettclinic.com BUILDING PERMIT APPLICATION Existing Use of Building:BUSiness Office Contract Price of Work:$_6,000 Proposed Use of Building:Business Office Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: XCommercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair XT.]. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK:THE PROJECT CONSISTS OF THE ADDITION OF A NEW PARTITION WITH A NEW DOOR TO AN EXISTING TENANT SPACE ON THE 4TH FLOOR.INTERIOR RENOVATIONS TO INCLUDE THE CONSTRUCTION OF NEW NON-BEARING STUD WALL PARTITION,GYP.WALLBOARD AND A NEW DOOR.MINOR MODIFICATIONS TO THE ELECTRICAL&MECHANICAL SYSTEMS AS REQUIRED.MODIFICATIONS TO THE FIRE-LIFE SAFETY AND.FIRE SUPPRESSION SYSTEMS WILL BE MADE AS,REQUIRED PER NEW ROOM CONFIGURATIONS. **ELECTRICAL,MECHANICAL,FIRE-LIFE SAFETY AND FIRE SUPPRESSION SYSTEMS TO BE BIDDER DESIGNED. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration —Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM !Chemical or Water I 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, and I comply with the State Contractors Law 18.27 RCW a.; ‘6.200A WAC. City ofEverettOfficialy� Use Only PERMI`T�Y#pp 1 7 V g - V I C Ow r/Au orae. Agent Signat - e (Revised 9/23/2016)