2930 MAPLE ST GROUP HEALTH 2018-11-13

PERMIT APPLICATIA BUILDING / MECHANICAL/PLUMBING /SIGN /SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink OhIy Please) PROJECT SITE INFORMATION." k " PROJECT SITE ADDRESS:2930 Maple Street, Everett, WA 98201 PROPERTY TAX#: 00439069505800 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Group Health Cooperative TENANT NAME(If Commercial): Group Health OWNER MAILING ADDRESS: STREET 2930 Maple Street CITY Everett STATE WA ZIP 98201 OWNER PHONE: 206-988-7692 OWNER EMAIL: Francis.Rodriguez@CBRE.com CONTRACTOR NAME: Auburn Mechanical CONTRACTOR ADDRESS: STREET 2623 West Valley Hwy N CITY Auburn STATE WA ZIP 98001 CONTRACTOR PHONE: 253-838-9780 CONTRACTOR EMAIL: JoshLee@auburnmechanical.com CONTRACTOR LICENSE#(REQUIRED): AU BU RMII63BA CITY OF EVERETT BUSINESS LICENSE#(REQUI- D):0 3236 PRIMARY CONTACT: 0 OWNER gl CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-261-5743 Josh Lee CONTACT EMAIL:JoshLee@auburn cba..l^aI coj BUILDING PERMIT APPLICATION -� Existing Use of Building: Contract Price of ork:$ Proposed Use of Building: Heat Source: ❑Gas Eloctrig a ether 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 DESCRIPTION OF WORK: (u .-y4i-i L. L „C/�/o(t+ASSOCIATED BUILDING PERMIT#(if applicab/5/4)-t, : MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION: Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn 4Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump 1 Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler 1 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 2 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION SYSTEM 'Number 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 to 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 4e_ lay//6 #_'J Owne Authorized Agent Signature ` Date (Revised 9/23/2016)