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PERMIT APPLICATIOh . <br /> #111111111 <br /> BUILDINI ECHANICAL/PLUMBING /SIGN Al RINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201. <br /> 4;0 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> Rucker Avenue, Everett,WA 98203 00582202200101,00582202200102, <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: 00582202200201,00582202200202 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Community Health Center of Snohomish County TENANT NAME(If Commercial):Community Health Ctr.of Snoho.County <br /> OWNER MAILING ADDRESS: STREET 8609 Evergreen Way <br /> cnTY Everett STATE WA zip 98208 <br /> OWNER PHONE: 425.789.3700 OWNER EMAIL: DKapetanov@chcsno.org <br /> CONTRACTOR NAME: J.R.Abbott Construction,Inc. <br /> CONTRACTOR ADDRESS: STREET 3408 1st Avenue South,Suite 101 <br /> CITY Seattle STATE WA ZIP 98134 <br /> CONTRACTOR PHONE: 206.467.8500 CONTRACTOR EMAIL: jeffvp@abbottconstruction.com <br /> CONTRACTOR LICENSE#(REQUIRED): JRABBCI 022 JZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016152 <br /> PRIMARY CONTACT: 0 OWNER ''CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206.467.8500 <br /> Jeff Vander Pol <br /> CONTACT EMAIL: jeffvp@abbottconstruction.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Business Office Contract Price of Work:$��// 9 t%.01 OOT) 015(17 <br /> Proposed Use of Building: 007 Heat Source: ❑Gas MElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: &Commercial ❑Industrial <br /> Type of Project: ONew CI Addition Remodel CI Repair ❑T.I. El Sign El Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION O ORK:The project consists of a remodel to an existi ••office building for u - .s a medical clinic and office space. 'te work to i e demolition of one drive ial sidewalk and <br /> some landscaping.New site ' elude parte ew sidewalk,some parking re-stripe ••relocatio-of existing generator to new pad.Structura dude seismic upgrade to buildi . nor renovations <br /> to include removal of interior partitions,p lighting and finishes.New work to include meta - ails,casework,ceiling systems,lighting,and fi ' es. electrical,mechanical, plumbin tems and <br /> modifications to fire-life safety and fir pression s as require by new work.Electrical, - anica,. i bing,fire-life safety and fire suppre on systems to a bidder designed and deferred permit. (� <br /> The work under this pe would Include only the site/Interior olition and site wor activities. [ r• DEA,o faP 7, <br /> ASSOCIATED UILDING PERMIT#(if applicable): B1705-065 f,11f1/ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water ' No.of Heads <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or/am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> /../C4 <br /> ( _.. i / f' / 7/ 7 PERT ltga ©V 5. <br /> er/Authorized g�ttf lgn ture / Date (Revised 9/23/2016) �=' <br />