1031 SE EVERETT MALL WAY COLDWELL BANKER 2022-10-06

Imo !MOLDING PERMIT APPLICAllipN 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 1031 SE Everett Mall Way PARCEL#: 280518003-083-00 CITYEverett STATE WA ZIP 98208 SUITE/UNIT#: 100 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): Coldwell Banker LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Everett Covenant Group LLC OWNER MAILING ADDRESS: STREET 2460 Paseo Verde Pkwy Suite 145 CITY Henderson STATE NV ZIP 89074 OWNER PHONE: 702-820-5600 OWNER EMAIL: taylorkim@pacden . 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: ❑OWNER ❑CONTRACTOR C OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE: 9 51-5 8 2-5 7 4 5 Julie Margetich CONTACT EMAIL: Margetichj@pacden . com BUILDING INFORMATION VALUATION OF WORK: $ 74, 815 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: suite currently empty- this will be first tenant PROPOSED USE OF BUILDING: Real Estate Office HEAT SOURCE: ❑Gas ©Electric ❑Other BUILDING TYPE: LISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ERepair ®T.I. ❑Change of Use ❑Modular EPortable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: 1, 151 , s . f; non structural partitions, one uni-sex toilet room T-bar ceiling with lights, outlets, interior finishes, mech . distribution, plumbing, cabinetry and 200 amp electrical panel . 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 AC. r 4/19/2 2 City of Everett Official Use Only 4, ,, PERN ul ("L�`'c Owner/Au orized Agent Signature Date (Revised 2/8/2021)