2500 HEWITT AVE LUTHERAN COMMUNITY SERVICES 2023-04-24

Ims BOLDING 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2500 Hewitt Ave PARCEL#: 00437869300900 clry Everett STATE Wa ZIP 98201 SUITE/UNIT#: 300,400 FLOOR#: First ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Lutheran Community Services Northwest- Building Tenant LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Lutheran Community Services Northwest OWNER MAILING ADDRESS: STREET 4040 S. 188th Street, Suite 300 CITY SeaTac STATE Wa ZIP 98188 OWNER PHONE:201-602-0911 OWNER EMAIL: pharris@Icsnw.Org 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) CONTACT NAME: CONTACT PHONE: Same as above CONTACT EMAIL: BUILDING INFORMATION VALUATION OF WORK: $82,300 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:Business Office PROPOSED USE OF BUILDING:Business Office HEAT SOURCE: ❑Gas ❑✓Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑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 ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Four additional offices with doors will be added by subdividing four larger offices in the space, two on each side of the long hallways. The wall which currently subdivides the conference room will be demolished to allow for a larger conference room. Additional electrical and data will be run to outlets where needed in the new offices. Sufficient HVAC return and supply, ceiling lighting and fire safety devices will be added where needed to the newly demised spaces. Paint and carpet will also be part of the project. 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 Digitally signed by Peter Harris Peter Harris DN cn=Paler Harris o=Lutheran Community Services PERMIT# Northwest,ou=Facilities.email=phamis@gmail.com. 9�1�/202� �^��Dn, 1 FL' 1 L /J� Ill Date:2022.09.12 05:08:35-07'00' Owner/Authorized Agent Signature Date (Revised 4/21/2022) I2