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� <br />• <br />PERMIT <br />• <br />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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: PROPERTY TAX # P MIT # <br />916 Pacific Avenue, Everett, WA 98201 29053000200100 �j O�j ��_�� <br />1L for new construction: Short PlaUsubdivision See 8tt8CF12(i CI@SC�IptIOCI Lot No. (attach copy of long legal description) <br />ER Fairfax Hospital Phone/E-mail ron.escarda@uhsinc.com <br />10200 NE 132nd Street <br />City/State/Zip Kirkland, WA 98034 <br />_ Owner _ Owner's Agent X Contractor _ Contractor�S A9Eflt _ T@f18f1t (must provide a letter ot consent from the ovmer to do work in the space) <br />iR BNBuilders, Inc. L& I Lic. # BNBUII`990K3 COE aus. �ic. # 043638 <br />2601 4th Ave, Suite 350, Seattle, WA 98121 Phone/Email 206.382.3443 <br />Fairfax Hospital <br />BUILDING PERMIT APPLICATION <br />Kevin Smith 206.473.2797 <br />Phone/E-mail kevin.smith@bnbuilders.com <br />CONTRACT PRICE OF WORK 3•`� 1►'�. I <br />Existing Use of Building Sleep Therapy Unit HEAT SOURCE: <br />Proposed Use of Building ACute Ca�e FaClllty Gas Electric X Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family X Commercial <br />Type of project: _ New Addition Remodel Repair X T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />To selectively demolish existing finishes and construct new architectural finishes within the existing floor plan to support a <br />new 30-patient bed facility for behavioral health patients. <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />1 A/C — air handling units <br />Forced air systems <br />Gas piping <br />1 Water heater <br />Gas fireplace <br />Gas range <br />2 Clothes dryer 6` <br />Ranae hood �A <br />1 Heat pump <br />Unit heater <br />W oodstove <br />Ducting <br />29 Other Induction Units <br />SPRINKLER / SUPPRESSION <br />184 I Number of Heads <br />�-f�t ►� lo6r <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of r�ctures <br />� g Toilet <br />Bathtub <br />16 <br />2 <br />Pa <br />Lavatory (wash basin <br />Shower <br />Kitchen sink 8� dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moK <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have 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 complied <br />with whether specfied herein or not. The 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 au[horized by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Digitally signed by Kevin Smith <br />Kev i n S m i t h DN cn=Kevin Smith, o=6NBuilders, ou, �,�� <br />email=kevin.smith@bnbuilders.com, c=US <br />Date: 2013.12.04 16:31:35 -OS'00' <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />