10318 EVERGREEN WAY WOODS COFFEE 2023-07-31

• BUILDING 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 10318 Evergreen Way PARCEL#: 00535200001001 CITY Everett STATE WA ZIP 98204 SUITE/UNIT#: N A FLOOR#: N/A ADDITIONAL LOCATION INFORMATION (if applicable): N A TENANT/BUSINESS NAME(if non-residential):Woods Coffee LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Commercial Lot No.: NA (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:TAYLOR HERMAN-WOODS COFFEE OWNER MAILING ADDRESS: STREET 191 18TH ST CIS, LYNDEN STATE WA ZIP 98264 OWNER PHONE:360.393.7553 OWNER EMAIL: TAYLORH@WOODSCOFFEE.COM CONTRACTOR COMPANY NAME:Kugel Construction WA STATE CONTRACTOR LICENSE#(REQUIRED):#KugelC`971 D4 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58426 CONTRACTOR ADDRESS: STREET 1722 Bishop Rd#8713 CITY Chehalis STATE WA ZIP 98532 CONTRACTOR PHONE:360 219 3555 CONTRACTOR EMAIL:adam.kugel@kugelconstruction.com PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360.319.3555 Adam Kugel CONTACT EMAIL:adam.kugel@kugelconstruction.com BUILDING INFORMATION VALUATION OF WORK: $$300,000 ASSOCIATED LAND USE PROJECT#(if applicable):Site Plan and Engineering Permits (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:N/A PROPOSED USE OF BUILDING:SINGLE LANE DRIVE-THRU COFFEE SHOP HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: R1Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): RNew Construction ❑Addition ❑Remodel ❑Repair ❑T.l. ❑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: CONSTRUCT 671 SF BUILDING FOR COFFEE SHOP WITH SINGLE LANE DRIVE-THRU PER ARCHITECTURAL AND ENGINEERED PLANS 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 PERM I.__ d2LI10/28/2021 14�� . Owner/A orized Agent Signature Date (Revised 2/8/2021)