1100 PACIFIC AVE EVERETT BONE AND JOINT 2018-12-14

PERMIT APPLICATIO� BUILDIN�MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: r/ � 1 �C�� PROPERTY TAX #: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Everett Bone and Joint TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srReeT 1100 Pacific Ave cirv Everett STATE WA ziP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME; Burns Fire Protection Systems, Inc. CONTRACTOR ADDRESS: srReeT PO Box 11 10 crrv Granite Falls STATE WA zia 98252 CONTRACTOR PHONE: 425-239-2698 CONTRACTOR EMAIL: keith@burnsfire.com CONTRACTOR LICENSE #(REQUIRED): BFPSLL"929MA CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 54660 PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: 425-239-2698 Keith Kyle coNTacT EMai�: keith@burnsfire.com BUILDING PERMIT APPLICATION Existing Use of Building: Medical Clinic Contract Price of Work: $ 4,800.00 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: �Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair {�T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use �EscRiPTioN oF woRK: gurns Fire Protection Systems to add 9 fire sprinkler head to meet new wall and room layout 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 #�f List of Fixtures # of List of Fixtures # of List of Fixiures Fixtures Fixtures Fixtures Fi�ctures A/C —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 9 Number of Heads ACKNOWLEDGEMENT: 1 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, sfate, and local law. The granting of a permit only authorizes approved wo�k and no deviations the�efrom. Deviations must fi�st be authorized in writing from fhe Building Officia/ before being authorized under any circums nce. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and / comply with the State Contractors Law 18.27 RC�i�96.200A WAC. City of Everett OHicial Use Only PERMIT # �z � � ..� � ( � l � � �z� � D e (Revised 10/12/2015) L �