2707 COLBY AVE DAVITA NEPHROLOGY PRACTICE 2020-02-19

4ETT PERMIT APPLI^4:TION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (F)everetteps@everettwa.gov I vvvvw.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITEcINFORMATION PROJECT SITE ADDRESS: 270 7 ( /Zy , Ju)`le lig PROPERTY TAX#: 0 Q V:_7 ;A,,...‹),5-66) /GJ LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 5.'Co *ASV 44k 5 A3 TENANT BUSINESS NAME(Commercial): �AU I TA- OWNER -OWNER MAILING ADDRESS: STREET PQ g(=>)( .5"-� 7 / CITY i.� (,�G STATE z,,,,,i ZIP c'Sr.2D(p OWNER PHONE: '5/...25---•02...57R- k..5-S f oo OWNER EMAIL: CONTRACTOR NAME: 4./0 MPhole' A Y1 CONTRACTOR ADDRESS: STREET / 7 c / / ye5 T CITY I" b//r0 STATE 4 </4 ZIP G 7.2 CONTRACTOR PHONE: 360 -79 y-8(o.2 / CONTRACTOR EMAIL: 7)1/ke ///j�( (�1/0L1C/(I;, Co-' - CONTRACTOR LICENSE#(REQUIRED): 6/149(7e i); U 3 3 CJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 3,?(o cip PRIMARY CONTACT: ❑OWNER REONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: e../.25---_3 8' `2_ ?9.2_2 /Yl) f C /4,-)i)v,')Z,i�1-4CONTACTEMAIL: M the e ttio e i ,Co Z-r7 BUILDING INFORMATION Existing Use of Building: 0( t. S Contract Price of Work: $ 3.2 � �. "o Proposed Use of Building: -14s2. Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: P�h � /ode Add gni s- sin/cS and , 7 n' ovr. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture List of Fixtures Fixture Fixture Fixture Count count List of Fixtures Count List of Fixtures Count List of Fixtures A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher 5 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains J Water Heater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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.I am the owner,or I am 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 PERMIT# n D + Y �� Ow�horizbd Agent Signatu D e (Revised 10/10/2018)