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0 PERMIT APPLICATION <br /> dew <br /> BUILDING / MECHANICAL/ PLUMBING / SIGN I SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 ' FAX 425-257-8857 l(E)everetteps@everettwa.gov I www.everettwa.govipermits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS�3003 W Casino RD Everett,WA 98204 PROPERTY TAX#: 28041000100200 <br /> LEGAL for neva construction: Short Platlsubd`visinn_ Lot No (attach copy of long legal description) See attached <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Everett (40-01 BLD) TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3003 W Casino RD Everett,WA 98204 <br /> CITY Everett STATE WA Zip 98204 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: MacDonald Miller <br /> CONTRACTOR ADDRESS: STREET 7717 Detroit Ave SW <br /> carr Seattle STATE WA zip 98106 <br /> CONTRACTOR PHONE: (206) 407-2614 CONTRACTOR EMAIL: joyce.Copley@macmiller.com <br /> CONTRACTOR LICENSE#(REQUIRED): MACDOFS980RU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 040665 <br /> PRIMARY CONTACT: ❑OWNER ® CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-407-2614 <br /> Joyce Copley CONTACT EMAIL: permits@macmiller.COm <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of BUildin : MEDICAL CENTER Contract Price of Work: $_10,000,00 <br /> Proposed Use of Building. MEDICAL CENTER Heat Source: []Gas IBJ Dectric ❑Other <br /> . <br /> Buildin Type: ❑SFR-Detached ❑SFR-Attached ❑lDu lex []Multi-Family-#of Units: ®_Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel EIRe air 19T.1. ❑Sign ❑Sprinkler ❑Demolition ❑Chan a of Use <br /> DESCRIPTION OF WORK: <br /> Replacing qty (4) existing drinking fountains with new ones in same locations <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn -x Alteration _Repair Type of Project: _New _Adds „Alteration Repair <br /> #ofList of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> acttG—Air Handling Units Heat Pump Toilet Backflow Preventer Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavator (Wash Basin) 4 Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Ran e Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: VAV Clothes Washer Medical Gas <br /> Range Hoodmo a amper_- Water Heater Other: Eyewash with valves <br /> Exhaust Fan Grilles Sink Service/Bar/Mop/etc. Other: Refer Box Connections <br /> SPRINKLER l SUPPRESSION SYSTEM <br /> Number of Heads <br /> 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 <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.1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> —._ <br /> - � � � I PERMIT# <br /> 12/16/2016 p� <br /> OwnerfAuthorized Agent Signature Date (Revised 10/12t241.5J <br />