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PERMIT APPLICATlON <br /> BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITiON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, WA 98201 -425-257•8810—PAX 425-257-8857 —�nnvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � — S �� <br /> SITEAODRESS: PROPER7YTAxU P MIT#�_O � <br /> 1700 13th Street <br /> LEGAL iar nmc canslruction: Shod Platlsubdivision__N!A__ ,_ __Lct Na._ (altach capy al long le9al dcrrip:icn) <br /> OWNER P�ovidence Regional Medical Center r�,;r,�d�-+����.i <br /> na��ess �321 Colby cnyisia�e2ip Evorett,WA 98�06 <br /> CONTRACTOR M.A.Mortensan L&I Lic.u 706�089-00-0 _ <br /> ta23o Nc Paints Drrvo,Suita 900 phonelEmail <br /> Addre55 KirklanG.WA 9803J � <br /> 7ENANT BUSINE55 NAME CONTACT FOR PERMIT Dan Huberty <br /> 20fi-521-3a02/dan.huberty@z^�com <br /> Phone/E-mail � <br /> BUIIDING PERMIT APPLICATION CONTRACT PRICE OF WORN SZa7,650.00 <br /> Erlsting Use of Building Hospi�al __ __ HEAT SOURCE ___ <br /> Hos it�l �.;as F.�ectr.c Ut^cr <br /> Praposed Use of Buildin9. � � --- ' <br /> 3uilding lype: _Single Family _Duplex_Tovmhouse _M�Iti•Family X Commercial <br /> Type of projecC _New _Addition �Remodel _Repair_T.I._Sign_Sprinkler_Demo�ition_Change of Use <br /> Description ol Work(additional space proviAed cn fho DackJ: <br /> At samh pede5trlan bntlpe constmctod as part oi tho Tower pmjed(Permi1000'1-021�,remove sleel rail on notlh sitla ol bnC9e and orect new glass wail matching�h:d <br /> a�Ihe saih,itle al the brid�e te�'�i�g�ie�nnd condit cns. /+����—.-'-----^"""='^`�'�'�o. <br /> Havo you started working withoul a permit7 X YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Proju[k _Now_Addn _A�terelion_Repair Typa of ProjocC _Naw_Addn _Allxralion_Ropair <br /> Show Num6er(N)of!irfures Show Number fN)ol(ixfuros i <br /> I NC-air handli:i�unds Toilet <br /> ; Forced air syslems 8�����0� <br /> Gas piping Lavatory(wash basin) <br /> 1^/alerhoalor � Shower <br /> � Gas fireplace Kitchen sink 6 dis osat <br /> Gas ran e I Dishwashor <br /> I Clothes dryer ' Cblhes washer <br /> ' Range hood Water heater <br /> I Exhausifan ' Sink(servicelbadmcple�a) _ <br /> � Heal pump Backflcw Preventer <br /> Unit hcatcr Urinal _ _ <br /> BOiler Dr.^hinq Foun;a�� _ <br /> Relri etalion Flocr drain <br /> Woodslove Grease trap <br /> Ouctin � Roof drains <br /> Other �� Medical Gas <br /> SPRINKLER I SUPPRESSION 3YSTEM I Other. <br /> � Other. <br /> Number of Hcads <br /> �r,�r,•hy c� b�i V�at I nnvo�caa an�ex,-�m�ned Ih��.aVP�.�:=��:''�'��know u'e same�o bo Wu and corteet.A pmvisions ol iaws a�d ordinances yavunrny <br /> th�r type oi•:.oik wll bo wm,CeJ��ill�wl�alher s�^_cliud nerein or ncL T•ie 9ra•i:in�ct a pormil dces nol p�escme lo give aulhuiity lo viola:e or cancn� <br /> the PfoviSion of an� nlner s;+;u v�ec,I I;�.v royululirg cu••rcD.�r,l u���u�Pm O�do��runcu d conslrr.cliv� 'Iml I om.nuUi<:ri:ed by lhe o�vner ol Ri�s 0'�V�"IY <br /> :n{wdtu lho�� ik�o h ,h al.�Ire,b n r m�du and I cornp.y w+�;he S'alo Coatractors!.x.v 18°7 RJVJ und 2P8 200'NAC <br /> ` � ��� ��: � - - � <br /> 1 l 6 tz <br /> OwnerlAuthodzedAgent5lgnatura-'"� , Oale (R0""`�0Z'���� <br /> `- L(� <br />