12906 19TH AVE SE IN N OUT PHO 2023-06-13

Ism BIDING PERMIT APPLICATICII 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(d@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 12906 Bothell Everett Hwy PARCEL#• 28053000406200 cri Everett STATE WA ZIP 98208 SUITE/UNIT#: #B FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential): In-N-Out Pho LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: David Lam OWNER MAILING ADDRESS: STREET 12906 Bothell Everett Hwy Suite#B CITY Everett STATE WA ZIP 98208 OWNER PHONE: 425.626.7171 ,, DoOWNER EMAIL: inandoutpho@gmail.com CONTRACTOR COMPANY NAME: - ,(ve 4'4 et. CD ei L ram, WA STATE CONTRACTOR LICENSE#(REQUIRED): 130)6141-kci25431krry OF EVERETT BUSINESS LICENSE#(REQUIRED): 63-39 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR El OTHER(Please Specify) Catch Design Studio CONTACT NAME: CONTACT PHONE: 206-322-4323 Rochelle Jones CONTACT EMAIL: permit@catchstudio.com BUILDING INFORMATION VALUATION OF WORK:$200,000 (ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall Include the prevaiing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: B-(cafe) PROPOSED USE OF BUILDING: B-(restaurant) HEAT SOURCE: ❑Gas DElectric DOther BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU DMulti-Family-#Units: ©Commercial DAccessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair QT.I. ❑Change of Use ❑Modular ❑Portable ORe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑PoovHot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Tenant improvement- interior alterations from existing starbucks into new Vietnamese restaurant. New interior finishes and new commercial kitchen equipment. 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 properly 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# (al/64202A 32-10S c) (9 Own Authorized gent gnature Date (Revised 2M2021)