10115 EVERGREEN WAY GROCERY OUTLET 2022-03-23

131. ODING PERMIT APPLICATt61 CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, WASHtkGTON 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: sTRET 10115 Evergreen Way PARCEL #: CITY Everett STATE Washington zip 96204 SUITEIUNIT #: FLOOR #: 1 ADDITIONAL LOCATION INFORMATION (if applicable): South Point Plaza TENANT/BUSINESS NAME (if non-residential): Grocery Outlet LEGAL DESCRIPTION for new construction_ Short Platlsubdivision: TI in existing building Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Greg Close OWNER MAILING ADDRESS: sTREE'T 14205 SE 36th St. Suite 215 ciTy Bellevue STATE WA zip 98006 OWNER PHONE: 425 990 6200 x 104 OWNER EMAIL: greggpaadvisors.com CONTRACTOR COMPANY NAME: TBD I & -I L s I + Vt in ur,- WA STATE CONTRACTOR LICENSE #(REQUIRED): 9. 1 U , CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Jesse Walker CONTACT PHONE: 847-788-9200 CONTACT EMAIL: jwalker@greenbergfarrow.com BUILDING INFORMATION VALUATION OF WORK: $ 1,000,000.00 1ASSOCIATED LAND USE PROJECT# (if applicable): (Valuabon shall include the prevaiing fair market value of al labor, materials, and equipment needed to complete the work, whether actually paid or not.) EXISTING USE OF BUILDING: Office Depot Retail Store PROPOSED USE OF BUILDING: Grocery Store HEAT SOURCE: ®Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑k"lulti-Family - # Units: ®Commercial ❑Accessory Structure TYPE OF PROJECT (check all that apply) : El 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: Project is a new retail grocery store In and existing strip center. Tenant Improvements include all interior modifications to add offices, loading area, fixtures and coolers/freezers. All new interior lighting, complete HVAC units and refrigerated cases. All new floor fixtures and check out stands as required to meet owners standard specifications. 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, slate, 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 Offrcc rn 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 compl' Contractors Law 18.27 RCW and 296.200A WAG. City of Everett Moat Use Only PERh�IIT� I _ 0311512021 Owi Signature Date ('Revised 2/&2021) Y2.,,