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BODING PERMIT APPLICAT40N <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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits <br />B/ue or Back "lnk f3nly Please) TSITE INFO PROJECRMATION <br />PROJECT SITE ADDRESS: STREET e7 jef GO H V CIV U C PARCEL #: Uu-'+39 I b240uu <br />CITY G V CriG I I STATE VVH ZIP 9 201 <br />SUITE/UNIT #: VARIOUS 3RD FLR/ALL OF 4TH FLOOR #: 3/4 ADDITIONAL LOCATION INFORMATION (if applicable): <br />TENANT/BUSINESS NAME (if non-residential): COMPASS HEALTH CARE (EVERETT CLINICS AND OFFICES) <br />LEGAL DESCRIPTION for new construction: Short Plat/subdivision. C V C Ir 1 C I I r- L-o Lot No.: 1 1 rV (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNERNAME:JB EVERETT LLC <br />OWNER MAILING ADDRESS: STREET 15203 SE 80TH ST <br />CITY IVtVVUfHJ I Lt STATE VVH ZIP y0u;Nj <br />OWNER PHONE: CIO 425-455-9976 <br />OWNER EMAIL: <br />CONTRACTOR COMPANY NAME: C P M N W E' / �.1�/`JrVC� <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): CC COMMEPM 784KF <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 64698 <br />CONTRACTOR ADDRESS: SMEET1509 BONNEVILLE AVE, SUITE A <br />CITY SNOHOMISH STATE VVH zip Z104W <br />CONTRACTOR PHONE:360-863-6705 <br />1CONTRACTOR EMAIL: STAPPEROPRNNW.COM <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑✓ OTHER (Please Specify) HI'1Vf11 I CV <br />CONTACT NAME: VICKI SOMPPI <br />CONTACT PHONE: 206-311 0-0827 <br />CONTACT EMAIL:vlckls0workplacearchltecture.com <br />BUILD1146 INFORMATION <br />VALUATION OF WORK: $ 55,000 <br />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: office <br />PROPOSED USE OF BUILDING: office <br />HEAT SOURCE: ❑Gas ❑Electric ❑Otherumbully kulln <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 OT.I. ❑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: <br />Minor demolition to combine 3 ex. suites to one for the Genoa <br />pharmacy which is part of the Compass Health Care -Everett clinic <br />relocation to the Everett Tower. One new partial wall to separate <br />the pharm work area from the inventory area and entry access. A <br />patient waiting area with a secured window. and a patient consulbi <br />ACKNOWLEDGEMENT. • 1 have reviewed this application and confirm 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 authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. l am the owner, or l am authorized by the owner of this property to perform the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />MIM - ly sign=by Vicki Somppi <br />=�s, E <br />kplae Architecure, OU=Principal,CN-VickiVicki Somp 'ciseic <br />8.8.20©A <br />PERMIT # <br />n <br />p <br />2022.08.0812:56:28-07'00' <br />c^O �D <br />Owner/Authorized Agent Signature <br />Date <br />(Revised 412112022) <br />Z <br />