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BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL 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 1321 SE Everett Mall Way PARCEL#: 2805180004800 <br /> cm. Everett STATE WA ZP 98208 <br /> SUITE/UNIT#: C FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):J &K Food Services, LLC DBA Angry Crab Shack <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: James and Karen Masse <br /> OWNER MAILING ADDRESS: STREET 14205 NE 171st St <br /> cm, Woodinville STATE Wa ZP 98072 <br /> OWNER PHONE: 20270180 OWNER EMAIL: jkfoodservices@yahoo.COm <br /> CONTRACTOR COMPANY N• E:T.B.D. TAp.mr ko t S Lt.0 ISA efifrif <br /> WA STATE CONTRACTOR L. ENSE#(REQ ED):comae- a/I 76 Crry OF EVERETT BUSINESS LICENSE#(REQUIRED): 6-46-9g <br /> CONTRACTOR ADDRESS: STREET p 0 ^AQ.Q Z . G� <br /> CITY 9 y QO /�(S STATE W,0 ZP /g2 .9/ <br /> CONTRACTOR PHONE: ,?gD, 6.3'. 7©S CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:425-252-2153 <br /> Todd Bullock CONTACT EMAIL:todd@2812architecture.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$100,000 ASSOCIATED LAND USE PROJECT#(if applicable):n.a. <br /> (Valuation that 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:A-2:restaurant <br /> PROPOSED USE OF BUILDING:A-2: restaurant <br /> HEAT SOURCE: ❑✓Gas ❑Electric DOther <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ✓❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition tRemodel ❑Repair CIT.I. ❑Change of Use <br /> ❑Modular ❑Portable ORe-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub OTank(above ground) ❑Other. <br /> DESCRIPTION OF WORK: <br /> Tenant improvements/remodel of existing restaurant to meet new restaurant's business <br /> model. Work includes demolition of non-load bearing walls and casework. New work to <br /> include casework, associated plumbing for a bar, and finishes. <br /> 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 <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.tam the owner,or I am authorized by the owner of this properly 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 /> 6/29/2022 PERMIT# <br /> in Z Z-01-7 - p 0 <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br /> '/2 <br />