111 SE EVERETT MALL WAY GWYTHER SALON 2021-11-02

I BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION:(P)425.257.8810 1(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION ' , PROJECT SITE ADDRESS: STREET 111 Everett Mall Way PARCEL#: 00480201300802 cmTY Everett STATE WA ZIP 98208 SUITE/UNIT#: FLOOR#:2nd ADDITIONAL LOCATION INFORMATION (if applicable):Building F TENANT/BUSINESS NAME(if non-residential):Gwyther Salons LEGAL DESCRIPTION for new construction: Short Plat/subdivision: blk 013 D-02 Lot No.:3 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Josh Gwyther OWNER MAILING ADDRESS: STREET 9615 11th Place SE cI,Y Lake Stevens STATE WA ZIP 98258 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:TBD WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ['OTHER(Please Specify)Architect CONTACT NAME: CONTACT PHONE:425 252-2153 Danielle Fowler: 2812 architecture CONTACT EMAIL:danielle@2812architecture.com BUILDING INFORMATION VALUATION OF WORK:$20,000 ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:busineSS PROPOSED USE OF BUILDING:business HEAT SOURCE: ['Gas ['Electric ['Other BUILDING TYPE: ❑SFR ['Townhouse ['Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ['T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:A tenant improvement for 1,637 SF of office space on the second floor of an existing building. 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 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 r7"e/% 702/ PERMITt26y Owner/Authorized Ag t Signatur ate (Revised 2/8/2021) 1�2