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BODING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION: (P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1010 SE EVERETT MALL WAY PARCEL#: 28051800306600 <br /> CITY EVERETT STATE WA ZIP 98028 <br /> SUITE/UNIT#: 202 FLOOR#: 2 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):AMERICAN RED CROSS <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:TENANT NAME IS AMERICAN RED CROSS ATTN: MATTHEW JONES <br /> OWNER MAILING ADDRESS: STREET 431 18th Street, NW <br /> CITY Washington STATE DC ZIP 20006 <br /> OWNER PHONE:801-209-1603 OWNER EMAIL: matthew.jones@redcross.org <br /> CONTRACTOR COMPANY NAME: <br /> X ni HA(tA WA STATE CONTRACTOR LICENSE#(REQUIRED): Com m r fill 1 4 rFCITY OFIO✓ERETT BUSINESS LICENSE#(REQUIRED): Lte q�� <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect until Contractor is selected <br /> CONTACT NAME: CONTACT PHONE:205.870.3090 <br /> Jonathan Perry CONTACT EMAIL:jonathan@livedesigngroup.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $777,500(ESTIMATED) ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:Business <br /> PROPOSED USE OF BUILDING:Business <br /> HEAT SOURCE: ❑Gas ❑✓Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair DTI ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: <br /> DESCRIPTION OF WORK: The project is a tenant fitout for the American Red Cross.The American Red Cross will use the <br /> ARCHITECT, space for Humanitarian Services(offices,training,accessiry storage)after the renovations are <br /> SUBMITTING FOR PLAN completed.The existing building has two stories,but the tenant space will only occupy a portion <br /> REVIEW.CONTRACTOR of the second floor.The building is in seismic design category D. <br /> IS TBD. <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirms the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The granting of a permit only authoI1zg.approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the-o5vner, <br /> arnl I comply with th,,StoA,Contractors Low 18.27 RCW and 206.200A WAC. <br /> City of Everett Official Use Only <br /> Digitally signed by Jonathan Perry P E RMJI,# <br /> Jonathan Perry DN uS,E=ionathan@livedesigngroup oom, <br /> �LE Design Group,ON=Jonathan Perry <br /> Date:2022.08.16 10:58:51-05'00' <br /> `— <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) J / <br />