305 SE EVERETT MALL WAY VISION WORKS 2022-06-28

LT.E BLDING 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 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 305 SE Everett Mall Way PARCEL#: CITY Everett STATE WA ZIP 98208 SUITE/UNIT#: Suite 21 FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Visionworks LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:ACF Property Management, Inc. OWNER MAILING ADDRESS: STREET 13835 N Tatum Blvd. Suite 9-620 CITY Phoenix STATE AZ ZIP 85032 OWNER PHONE:480-607-7741 OWNER EMAIL: rwilcox@acfpm.com 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: 0 OWNER ❑CONTRACTOR ✓❑OTHER(Please Specify) Erin Vickrey-permit expediter-Scout Services CONTACT NAME: CONTACT PHONE:630-796-0557 Erin Vickrey CONTACT EMAIL:evickrey@scoutservices.com BUILDING INFORMATION VALUATION OF WORK: $250,000 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:M-Mercantile PROPOSED USE OF BUILDING:M-Mercantile HEAT SOURCE: ❑✓Gas ❑Electric ❑Other BUILDING TYPE: ESFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ECommercial ❑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: Empty Tenant Space to be fit-out for a Visionworks Retail Store. 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# 2_1 O9- OO 0 ZO 9/3/2021 O thorized Agen ignature Date (Revised 2/8/2021)