1520 SE EVERETT MALL WAY 2022-04-28

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: `>-" 'Se Everett Mall Way PROPERTY TAX#:28051 800401 1 00 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 3773 Investments LLC TENANT BUSINESS NAME(Commercial): Goodyear OWNER MAILING ADDRESS: sTREET433 North Camden Dr Ste 800 crry Beverly Hills STATE CA ZIP 90210 OWNER PHONE: 4254987711 OWNER EMAIL:megan.ricahrd@anteagroup.com CONTRACTOR NAME:Clearcreek Conctractors CONTRACTOR ADDRESS: STREET 3203 15th St ciTv Everett STATE Wa Zip 98201 CONTRACTOR PHONE:360-659-2459 CONTRACTOR EMAIL:markm@clearcreekcon.com CONTRACTOR LICENSE#(REQUIRED):CLEARCI997K1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 38969 PRIMARY CONTACT: El OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-423-8120 Mark McCullough CONTACT EMAIL:markm@clearcreekcon.com BUILDING INFORMATION Existing Use of Building:Former Goodyear Service Center Contract Price of Work: $68,430.00 I Proposed Use of Building: Heat Sourc4: ❑Gas ❑Electric DOther BUILDING USE: ❑SFR L. (Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Uriits. ❑✓Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel XRepair ❑T.I. ❑Sign ❑Sprinkler ❑(Demolition ❑Change of Use DESCRIPTION OF WORK: Remedial excavation under the footing of the existing building. The project will include surface demolition, temporary shoring of columns and footings. Excavation and disposal of petroleum impacted soils. Backfilling excavation with CDF and surface restoration to match existing surfaces. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures 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 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 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 A_ 4 jt( Ciat& PERM( T)/( (Z 41( 19 ( 2 -0 Owner/Authorized Agent Signature Date (Revised 10/10/2018) /7