4004 COLBY AVE 2019-03-14 - Laserfiche WebLink

PERMIT APPLICAT1011— BUILDIN 1ECHANICAL/ PLUMBING /SIGN _—RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits • (Blue or Black Ink Only Please) . PROJECT SITE.INFORMATION, PROJECT SITE ADDRESS: 4004 Colby Avenue PROPERTY TAX#: 0041130110290000 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: The Everett Clinic TENANT NAME(If Commercial): The Everett Clinic OWNER MAILING ADDRESS: STREET 3901 Hoyt Ave. CITY Everett STATE WA Zip 98201 OWNER PHONE: 425-328-6825 OWNER EMAIL: mgriffith@everettclinic.com everettclinic.com CONTRACTOR NAME: The Everett Clinic CONTRACTOR ADDRESS: STREET 3901 Hoyt Ave. CITY Everett STATE WA zip 98201 CONTRACTOR PHONE: 425-328-6825 CONTRACTOR EMAIL: mgriffith@everettclinic.com CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 9 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE'4255-328-68255 S %S Mike Griffith CONTACT EM L: mgriffithAeverettclinic.com •..r('te BUILDING-'PERMIT APPL N 4;;® Existing Use of Building:Medical Office building Contract Price of Work:$40,000 Proposed Use of Building:Medical Office building Heat Source: ❑Gas 0Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: laCommercial 0 Industrial Type of Project: CI New ❑Addition EtRemodel CI Repair CIT.!. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Interior work only, no exterior work. The project consists of remodeling 402sf into a staff lounge, utility Iroom and office. New work to include metal stud partitions, casework,flooring, some-newrPili_ ac ssv to s and4ig1 and minor modifications to electrical and mechanical systems. Modifications to Fire-Life Safety systems as required by new work. Fire-Life safety permit to be deferred submittal. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION „F , Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn Alteration _Repair #of #°f List of Fixtures List o Fixtures #of List of Fixtures #°f List of Fixtur s Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units eat Pump Toilet Backflow Pre er(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) nking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal / Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Drye 'ookups Other: Clothes Washer Medical Gas Range Ho Water Heater Other: Exhau an Sink(Servi ar/Mop/etc.) Other: S INKIER/SUPPRESSION SYSTEM Chemical or Water I No.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.lam the owner,or lam 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 KlAa)4 ILUsS Pic 'dt6 O97.1"kikkt-- uthorized Agent,Slyre_ L yA to (Revised 9/23/2016)