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IT • • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PE IT#� <br /> 4027 Hoyt Ave. 00582101101100 1(.� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Ralph J. McCarty Family LP Phone/E-mail <br /> Address 2623 Taylor Dr. City/State/zip Everett, WA 98203 <br /> APPLICANT:_Owner Owner's Agent _Contractor _Contractor's Agent X Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR The Everett Clinic iState Lic.# City Bus.Lic.# <br /> Address 3901 Hoyt Ave, Everett WA 98201 Phone/Email 425-328-6825 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Scott Lawson <br /> The Everett Clinic HL ►tL. 456vrGG5 425-259-1162 <br /> Phone/E-mail slawson everettclinic.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $10,000 <br /> Existing Use of Building Medical Office HEAT SOURCE: <br /> Proposed Use of Building No Change Gas_ Electric_ Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: New Addition Remodel Repair XT.l. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back):The project is a tenant Improvement in an existing <br /> medical office building. Interior renovations to include removal of two wall partitions. Modify fire-life <br /> safety systems as required per new room configurations. Area of remodel = 275 sf <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin) <br /> Water heater ? Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> I Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan i Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater ( Urinal <br /> I Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove j Grease tra <br /> i <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I h v read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether spec'a re' or n granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am a or of thi r o rm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Own utho zed'Ag ant 1gnature Date (Revised 9/2014) ,iZ <br /> //3 <br />