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ERMIT APPLICATIO <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 R�VIIT #; �1,l <br />916 Pacific Avenue, Everett, WA 98201 29053000200100 � ��("�- — VV <br />GAL for new construction: Short PlaUsubdivision See attBCfled d@SCflptl011 Lot No. (attach copy of long legal description) <br />INER Fairfax Hospital Phone/E-mail ron.escarda@uhsinc.com <br />Iress 10200 NE 132nd Street City/State/Zip Kirkland, WA 98034 <br />PLICANT: _ Owner _ Owner's Agent X COf1tf8CiOf _ COf1tf8CtOf S AgBllf _ T@f18f11 (must provide a leder of consent from the owner to do work in the space) <br />�NTRACTOR McKinstrv Companv �& � ���. # Mucsti c.� �ya �w COE Bus. Lic. # y�aa� <br />h Seattle. WA 98134 <br />Fairfax Hospital <br />BUILDING PERMIT APPLICATION <br />Phone/Email 206.762.3311 <br />R PERMIT <br />Brett Sontra 206.786.6002 <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building Sleep Therapy Unit HEAT SOURCE: <br />Proposed Use of Building Acute Care Facility 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 />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 />2 <br />Exhaust� <br />1 Heat pump <br />Unif heater <br />Woodstove <br />Ducting <br />29 Other induction Units <br />SPRINK�R / SUPPRESSION SYSTEM <br />184 I/ Number of Heads <br />PLUMBII�G PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />�g Toilet ' <br />Bathtub <br />�a Lavatorv (wash basi <br />Shower i <br />Kitchen sinl � dis <br />Dishwasher <br />2 Clothe"s washer <br />ater heater <br />Si (service/bar/m <br />Back w preventer <br />Urinal <br />Drinking F ntain <br />2 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 specified 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 authorized 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 />_ %?'%.�� �i--� r� J �C� jl•� <br />Owner/Authof'ried Agent Signature Date <br />1 <br />(Revised 6/2012� <br />