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PERMIT APPLICATI • <br /> BUILDII U I MECHANICAL/PLUMBING /SIGI41 PRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only-Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:2930 Maple Street, Everett, WA PROPERTY TAX#: 00439069506100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> . _. T; ONTACT'INPO�tMATIOI ` <br /> OWNER NAME: Group Health Cooperative TENANT NAME(If Commercial): Group Health Cooperative <br /> OWNER MAILING ADDRESS: STREET 2930 Maple Street <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 206-988-7692 OWNER EMAIL: brenda.mccray@CBRE.com <br /> CONTRACTOR NAME: Auburn Mechanical <br /> CONTRACTOR ADDRESS: STREET 2623 West Valley Hwy N <br /> crry Auburn STATE WA ZIP 98001 <br /> CONTRACTOR PHONE: 253-838-9780 CONTRACTOR EMAIL: Joshlee@auburnmechanical.com <br /> CONTRACTOR LICENSE#(REQUIRED): AUBURMI163BA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):033236 <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-261-5743 <br /> Josh Lee CONTACT EMAIL:Joshlee@auburnmechanical.corn <br /> l BUILDING PER T APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ Vt.bOO <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial CI Industrial <br /> Type of Project: El New ❑Addition El Remodel ❑Repair DTA. ❑Sign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Remove toilets, extend water lines for new wall thickness, reinstall toilets . <br /> Toilet carriers will remain in existing location . No waste or vent pipe mods . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> -MECHANICAL PERMIT APPLICATION <br /> -:. ! : . PLUMBING PERMIT)►PPLICATION . <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: _New _Addn i _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump 4 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 /> '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.lam the owner,or lam 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 /> PE T t 0 6 <br /> 06. <br /> Owner/ uthorized Agent Signature Date (Revised 9/23/2016) <br />