15 SW EVERETT MALL WAY HOTWORX 2024-04-02

• 111 Inn 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 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 15 SW EVERETT MALL WAY PARCEL#: 00480201101400 cm(EVERETT STATE WA DID 98204 SUITE/UNIT#: D FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):HOTWORX STUDIO LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:ROSEN BEL-KIRK ASSOCIATES LLC OWNER MAILING ADDRESS: STREEI PO BOX 5003 clT- BELLEVUE STATE WA zIP 98009 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:TBD l0> , C1^15 n cy,o Q WA STATE CONTRACTOR LICENSE#(REQUIRED): C�LOsr�,L��j5E5D CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1(0 1 I , CONTRACTOR ADDRESS: STREET 3�p O I R,�(,c j k' -CITY e,,p.. �� STATE W �/L-PC ZIP ' 8 D -'2f CONTRACTOR PHONE: J l 331 - 24 Z3 CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR I✓1 OTHER(Please Specify)designer CONTACT NAME:CNS DESIGN LLC CONTACT PHONE:425-941-9494 CLOVER SCHULER CONTACT EMAIL:CIOVer@designbycns.com BUILDING INFORMATION VALUATION OF WORK:$55000 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 oaid or not.) EXISTING USE OF BUILDING:`B" (PROFESSIONAL SERVICES) PROPOSED USE OF BUILDING:"B" (PROFESSIONAL SERVICES) 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 ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure EFence over 7ft high ❑RackStorage ❑Pool/Hot Tub ETank(above ground) ❑Other: DESCRIPTION OF WORK:APPROX. 1,625 S.F. TENANT IMPROVEMENT FOR NEW HOTWORX LOCATION. NO CHANGE OF USE REQUIRED. CURRENT TENA V , ti. OCCUPANCY) b.l , '' DEC 15 2023 CITY OF E\/ER TT ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work donepeoprroth6enviailamply 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 wit a State Contractors Law 18,27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/Auth rued Agent Signature Date (Revised 4/21/2022)