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PERMIT APPLICATIO <br /> � BUILDIN�ECHANICAL/ PLUMBING / SIG RINKLER/ DEMOLITION <br /> f� CITY OF EVERETT PERMIT SERV' <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2707 Colby Ave, Suite 718 PROPERTY TAX#: 00439162500100 <br /> LEGAL for new construction: Short Plat/subdivision EVERETT PLAT OF BLK 625 D-00 Lot No. 1-11 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: DaVita Kidney Care TENANT NAME(If Commercial): DaVita Nephrology Practice Assoc. <br /> OWNER MAILING ADDRESS: STREET 32275 32nd Ave S <br /> CITY Federal Way - STATE WA ZIP 98001 <br /> OWNER PHONE: (253)733-4830 OWNER EMAIL: Kristin.Videto@davita.com <br /> CONTRACTOR NAME: Axiom Northwest Construction, Inc. <br /> CONTRACTOR ADDRESS: STREET 2232 Broadway, Suite 101 <br /> crry Everett STATE WA DP 98201 <br /> CONTRACTOR PHONE: (425)903-4038 CONTRACTOR EMAIL: james@axiomnw.com <br /> CONTRACTOR LICENSE#(REQUIRED): AXIOMNC920LJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054458 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR r,ii OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: (425) 582-5510 <br /> Loren Vine CONTACT EMAIL: (vine@waremalcomb.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:Office Contract Price of Work:$ 120,000 <br /> Proposed Use of Building: Office Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: IaCommercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel ❑Repair 0T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: -Mg.',CaTH15 ptteMEC 'ibIG4.1aDF,61w DE 4•tPlot4 of l iti,T11.tcc*N' aw&VARU1 oIIS; AQGttt014Ott sum <br /> L1411 A/ 5 "4"A Cm4M41t4 "4a.W,k,() u ht7[Rucfot,L OF' 01;;Plabi EXAM)chlout. 'floM)R P[lonl,vomit* L& ,comtutersNa.1 <br /> Arlt)etwitic.pootvp,fw.P1,464145; 14•19rAU MMI.44/41 lW-.4 PlIOSf.I12a. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION j PLUMBING PERMIT APPLICATION <br /> Type of Project: New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixt -s #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat .mp Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems it Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink : s isposal Grease Trap <br /> Gas Range Ducting Dishwash- Roof Drains <br /> Clothes Dryer Ho.-ups Other: Clothe " asher Medical Gas <br /> Range Hood W. r Heater Other: <br /> Exhaust F. nk(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> 'Chemical or Water I No.of Heads <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# 1 )„..0Li <br /> Owner/ thorize gent Signature Date (Revised 9/23/2016) , <br />