1615 75TH ST SW PACE 2022-07-14 - Laserfiche WebLink

BNLDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHf NOTON 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 1615 75th St SW PARCEL#: 28041100101100 any Everett, STATE WA zip 98203 SUITEJUNIT#:[220 FLOOR#:2nd ADDITIONAL LOCATION INFORMATION (if applicable):Ewan TechnIcal Park 1 TENANT/BUSINESS NAME(if non-residential): I PACE in Everett LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Sabey Corporation OWNER MAILING ADDRESS: STREET 12201 Tukwila International Blvd any Seattle STATE WA ZIP 98168 OWNER PHONE: 2 0 6 . 2 81. 8 7 0 0 OWNER EMAIL: joes@sabey.com r CONTRACTOR COMPANY NAME:Ron Hutchinson '-(,�/� l.(4 r r DIY l�'1'RLfl 7VI 1 nu WA STATE CONTRACTOR LICENSE#(REQUIRED): HUTCHCCO 7 5 LP CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): Applied Fc r CONTRACTOR ADDRESS: STREET PO Box 482 any Manchester STATE WA ZIP 98353 CONTRACTOR PHONE:360.710,2380 CONTRACTOR EMAIL;hutchconinc@msn.cOm PRIMARY CONTACT: ©OWNER LI CONTRACTOR ❑✓ OTHER(Please Specify)Architect CONTACT NAME: CONTACT PHONE:206.962,6459 John R. Leuck CONTACT EMAIL:john.leuck@mg2.com BUILDING INFORMATION VALUATION OF WORK:$ 1, 395, 000 . 00 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: Empty PROPOSED USE OF BUILDING: Business.and 1-4 Adult Day CAre_ HEAT SOURCE: ❑Gas Cl Electric ❑Other BUILDING TYPE: EISFR ❑Townhouse ❑Duplex DADU ❑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 LiTank(above ground) LiOther: DESCRIPTION OF WORK Tenant improvement for a new work space for the PACE (Program for All- inclusive Care for the Elderly) team for Providence. The space will have Day Care spaces for the Elderly, and Business portions. No structural or exterior work to be done. All interior. 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 l am authorized by the owner of this property to perform the work for which application is made, and l comply with the State Contractors Law 18.27 ROW and 296.200A WAC. City of Everett Official Use Only PERMIT# 03 .23 .2021 -feP203 - oIIT I Owner/Authorized Agent Signature Date {Revised 2/8/2021)