1010 SE EVERETT MALL WAY BASE FILE 2023-06-16

.000 E BDILDING PERMIT APPLICATI!N 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 1010 SE Everett Mall Way PARCEL#: 28051800306600 kin. Everett STATE WA ZIP 98208 SUITE/UNIT#: 203 and 210 FLOOR#: 2nd ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Everett Mall Office Building LEGAL DESCRIPTION for new construction: Short Platlsubdivision: NA Lot No.:NA (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Everett Mall Office Building LLC OWNER MAILING ADDRESS: STREET 1010 SE Everett Mall Way, Ste102 CITY Everett STATE WA ZIP 98208 OWNER PHONE:425.330.6882 'OWNER EMAIL: rkirtley@kirtleysite.cOm CONTRACTOR COMPANY NAME:CPM I Tenant Improvement Solutions WA STATE CONTRACTOR LICENSE#(REQUIRED);COMMEPM784KF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64698 CONTRACTOR ADDRESS: STREET 1509 Bonneville Ave, Ste.A cay Snohomish STATE WA zip 9S290 CONTRACTOR PHONE:360-863-6705/425.330.2243 CONTRACTOR EMAIL:miazeolla@cmpnw.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect CONTACT NAME: CONTACT PHONE:206.852.5192 Chris Reinhart, SCR Architects CONTACT EMAIL:chris@scr-arch.com BUILDING INFORMATION VALUATION OF WORK:$165,000 ASSOCIATED LAND USE PROJECT#(if applicable):NA (Valuation shalraclude the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or noiT EXISTING USE OF BUILDING:Business Offices *Ct/ ! Aktet,i,, o PROPOSED USE OF BUILDING:Same As Existing 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 OModular ❑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: Tenant improvement work to provide the labor and materials to complete the following: Door hardware, relite glass install, framing, drywall and painting, spot replacement or repair of ACT, new flooring throughout, new appliances, casework and window treatment. Also includes new line and low voltage work. ACKNOWLEDGEMENT:l 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/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 ie4r;tAait 5' .A �u 2/10/2023 PERMIT# Z 3 0 1- 0 g 3 OwnerlAuthorized Agent Signature Date (Revised 4/21/2022)