830 80TH ST SW RENU MEDICAL 2023-08-01

t • • BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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 830 80th Street SW PARCEL#: 28041200305300 CITY Everett STATE WA ZIP 98203 SUITE/UNIT#: B-100 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Renu Medical LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Covewood Manor, LLC c/o Puget Sound Properties OWNER MAILING ADDRESS: STREET 600 108th Ave. NE, Suite 340 crn, Bellevue STATE WA ZIP 98004 OWNER PHONE:425-586-5601 OWNER EMAIL: Ishephard@nai-psp.com CONTRACTOR COMPANY NAME:/ C Gt, 90-c e-(`'WA STATE CONTRACTOR LICENSE#(REQUIRED): ACGL Q NiCM l &Q CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): LI/ 3 CONTRACTOR ADDRESS: STREET CITY STATE WA ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect at Lance Mueller Architects CONTACT NAME: CONTACT PHONE:206 325 2553 Harold Christensen CONTACT EMAIL:haroldc@Imueller.com BUILDING INFORMATION VALUATION OF WORK:$142,000 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:Office (B), Manufacturing (F-1), Storage (S-1) PROPOSED USE OF BUILDING:Same (no change of use). HEAT SOURCE: Z 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: Demolish existing production area janitor closet. Construct new men and women production area restrooms with janitor closet. Add new drinking fountain with bottle filler in existing break area. 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 PERMIT# ^ t®P (5 6-8-21 b Owner/Authorized Agent Sign ure Date (Revised 2/8/2021)