2930 MAPLE ST GROUP HEALTH 2018-11-13

PERMIT APPLICATIC: BUILDINV 1 MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2930 Mapl@ StC@@t, Everett, WA 98201 PROPERTY TAX#: 00439069505800 LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Group Health Cooperative TENANT NAME(If Commercial): GI'OUp H281th COOpeI'atlV2 OWNER MAILING ADDRESS: sTReET 12501 E Marginal Way S �„-,.Tukwila sTnrE wa ZiP 98168 OWNER PHONE: 20C-J88-7692 OWNER EMAIL: Francis.Rodriguez@CBRE.com CONTRACTOR NAME; Auburn Mechanical CONTRACTOR ADDRESS: srREEr 2623 W Valley Hwy N crrv Auburn STATE WA ZiP 98001 CONTRACTOR PHONE: 253-838-9780 CONTRACTOR EMAIL: Joshlee@auburnmechanical.com CONTRACTOR LICENSE#(REQUIRED): AUBURM1163BA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):O33Z36 PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-261-5743 Josh Lee CONTACT EMAIL:JoshLee@auburnmechanical.com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other 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: �(7 i�''�'U�L�Sl✓Ul:� 'i'� ��i�i.S Z�C�� r�C3 :/UU: L��.�'��'l,%�S` �� v��'�� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn ,LAlteration _Repair Fixtu es List of Fixtures Fixtures List of Fixtures Fixtu es List of Fixtures Fixtures List of Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler z 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 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:I have reviewed this app/ication and confirm the information contained herein is t�ue and correct. Work done pursuant to this pe�mit must comp/y 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.1 am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# � i� ( ( � - D�$ Owner/Aut rized Age ignature D te (Revised 9/23/2016)