4201 RUCKER AVE COMMUNITY HEALTH CENTER 2019-04-10

PERMIT APPLICATID— ,I1Poil BUILDINd-IIAECHANICAL/ PLUMBING /SIGI RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES *WI' ' rl r,. 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please)'` PROJECT SITE INFORMATION 420 Rucker Avenue,Everett,WA 98203 00582202200101,00582202200102, PROJECT SITE ADDRESS: ) PROPERTY TAX#: 00582202200201,00582202200202 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Community Health Center of Snohomish County TENANT NAME(If Commercial):Community Health Ctr.of Snoho.County OWNER MAILING ADDRESS: STREET 8609 Evergreen Way CITY Everett STATE WA ZIP 98208 OWNER PHONE: 425.789.3700 OWNER EMAIL: DKapetanov@chcsno.org CONTRACTOR NAME: J.R.Abbott Construction, Inc. CONTRACTOR ADDRESS: STREET 3408 1st Avenue South,Suite 101 crry Seattle STATE WA ZIP 98134 CONTRACTOR PHONE: 206.467.8500 CONTRACTOR EMAIL: jeffvp@abbottconstruction.com CONTRACTOR LICENSE#(REQUIRED): JRABBCI 022 JZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRj I): 016152 PRIMARY CONTACT: 0 OWNER ''CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206.467.8500 Jeff Vander Pol CONTACT EMAIL: jeffvp@abbottconstr_ .com BUILDING PERMIT APPLICATIONrooms-ti i-t3 Existing Use of Building: Business Office Contract Price of Work:/,/ 140,000.00 Pli-v--5-0Q-Y, Proposed,Use of Building: Medical Clinic&Office Heat Source: ❑ pc Gas ja Electric Other ? r Building.Type: ❑SFR-Detached ❑SFR-Attached El Duplex ❑Multi-Family-#of Units: 'A Commercial El Industrial Type of Project: El New DAddition BVRemodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use _ DESCRIPTION OF WORK:Tl s j consists of a remodel to ' ng office building for use as cal clinic and office space.Site u demolition of one driveway,pard alk and some landscaping.New site w dude partial new sidewalk, arking re-striping and relocatio Slating generator to new pad.S a work to include seismic upgrade to ' ' . erior renovations to include removal of i partitions,plumbing,lighting fishes.New work to include met walls,casework,ceiling syste ting,and finishes.New electrical, al,and plumbing systems and modifications to fi I e safety and fire suppressions s as require by new work.Electric mechanical,plumbing,fire-life saf 'and fire suppression systems to be bi er designed and deferred permit. The work under this permit would include only the foundation and piling activities. ASSOCIATED BUILDING PERMIT#(if applicable): B1705-065 FOOTV I „e\ /j V 5j/O( . UD9Y4cie MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION, Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn Alteration7 Repair #of List of Fixtures #of List of Fi.,res #of List of Fixtures #of ' List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Hea - mp Toilet ckflow Preventer(Inside Bldg) Forced Air Systems - it Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) i Drinking Fountain Water Heater Refrigeration Shower / Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposa/ Grease Trap Gas RangeDucting Dishwasher / Roof Drains Clothes Dryer H••kups Other: Clothes Washer Medical Gas Range Hood Water Heate- Other: Exhaust n Sink(S ce/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water I INo.of Heads ACKNOWLEDGEMENT:I 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,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance:I am the owner,or I am authorized by the owner of this property td perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. • City of Everett Official Use Only PERMIT / // "�� • t � 03I /� 0, 7-..- -/- '1 ') er/ uthorized Agent Signatur Date (Revised 9/23/2016)