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P�RMIT APPLICAT16N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS <br />PARCEL TAX I.D. M <br />PERMIT 0 <br />4205 Rucker AVe. <br />00582202200101 <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. 1 <br />22 <br />OWNER ADDRESS ZIP PHONE <br />3901 Hoyt Ave. <br />The Everett Clinic Everett, WA 98201 (425)259-0966 <br />TENANT NAME G/L/Jr,&.S I <br />CONTACT NAME —),CAA/ k- �lRr, PHONE <br />7 �{G <br />TEC - Accounting Departme',t <br />David Wildman Aoec-, (425)339-5465 <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE 0 <br />The Everett Clinic 3901 Hoyt Ave. <br />PHONE Everett, WA 98201 <br />(425)327-4726 <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />Addition <br />HEAT SOURCE <br />Office (no change) <br />PERMIT <br />TYPE <br />H Combination Plumbing <br />Demolition D Sign <br />IWORK <br />TYPE <br />N Alleratlon <br />New <br />17� Electric <br />B Gas <br />Sprinkler <br />Repair/Maim. <br />Other <br />CONTRACT PRICE OF WORK $248, 715.00 ( including M&E) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />Remodel to first floor bank of an existing office building for use as an Accounting Office. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />' <br />NO, TYPE OF FIXTURE OR ITEM <br />I <br />WATER CLOSET <br />_ <br />A/C — A/HANDLING UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />Z_ <br />,LAVATORY (WASH BASIN) <br />HEAT PUMP <br />— <br />OWER <br />UNIT HEATERS <br />K CHEN SINK 8 DISPOSA <br />— <br />CLOTHES DRYER <br />— <br />DIS WASHER <br />NGE HOOD <br />_ <br />LAU RY TRAY <br />W R HEATE <br />CLOTH S WASHER <br />META IREP CE/STOVE I <br />_ <br />URINAL <br />FIREPLA SERT <br />_L <br />DRINKING OU A <br />— <br />GAS FIR I E <br />_ <br />FLOOR DRAI <br />_ <br />GAS GE <br />BACKFLOW VENTER <br />GA IPING <br />1 <br />SINK (SE ICE/ R/MOP/ETC.) <br />E AUST FAN <br />1_ <br />OTHER use of existing <br />_x <br />THER Bidder design <br />lay. nd urinal`. <br />ar,rion o existing <br />_ <br />Bi er desi n alterations <br />HI"VAC system. <br />— <br />system. <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Feb 18 2002 <br />igna ure of wn r for �#NlMg Dale ` <br />