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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PE MIT # 22 <br />11 <br />3901 Hoyt Ave. <br />00411300600101 <br />LEGA LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. 1-9 & 27-29 <br />006 D-01 <br />Climax Land Company <br />OWNER ADDRESS CITYIZIP PHONE <br />The Everett Clinic 3901 Hoyt Ave. Everett, 98201 425-339-4286 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />The Everett Clinic <br />architectural Werks, Inc. 425-823-2244 <br />Janet Monda E.MAILjanet@awerks.com <br />CONTRAS Evverett Clinic 39101ESHoyt Ave. rvere� ,IP98201-327-4726 <br />pahoney <br />CONTR. LICEASe <br />USE OF BUILDING <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Medical Clinic <br />_Electric _ Gas _Other $150,000.00 <br />WORK DESCRIPTION <br />Approximattiy 1,356 square feet renovation to an existing <br />Medical Clinic. <br />Locos i0 - laar5 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A1C— air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />Sink (servicelbar/moplel, ) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />— <br />Heat pump <br />Urinal <br />_ <br />Unit heater <br />Drinking Fountain <br />_ <br />Boiler <br />_ <br />Floor drain <br />_ <br />Refrigeration <br />_ <br />Grease trap <br />_ <br />Woodslove <br />Rool drains <br />_ <br />Other_ <br />_ <br />_ <br />Other _ <br />— <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br />I hereby certify that I have read and examined Ihis application and know the same to be true and correct. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or not. The granting of a peril does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply vnlh the <br />Slate C mc16rs L w 18 7 RCW and 296.200 WAC. <br />Sign re of Owner/Contra rlAuhorized Agent halo <br />