15 SW EVERETT MALL WAY NOVEL EYES 2024-06-12

BUSDING PERMIT APPLICATI.J 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 15 SW EVERETT MALL WAY PARCEL#: 00480201101400 CITY EVERETT STATE WA ZIP 98204 SUITE/UNIT#: K FLOOR#: ' ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential):NOVEL EYES LEGAL DESCRIPTION for new construction: Short Plat/subdivision: EXISTING BUILDING Lot No.: EXISTING BLDG (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:ROSEN BEL-KIRK ASSOCIATES LLC.c/o ROSEN HARBOTTLE OWNER MAILING ADDRESS: STREET 1800 112TH AVE NE, SUITE 310 CITY BELLEVUE STATE WA ZIP 98004 OWNER PHONE:(425) 289-2222 OWNER EMAIL: brians@rosenharbottle.com CONTRACTOR COMPANY NAME: 4417 4:0 tvLt 9._C Art— W 05 j�.M A)m') t% WA STATE CONTRACTOR LICENSE#(REQUIRED):CO 4 E4-C 34.0 tA3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) ARCHITECT-AGENT CONTACT NAME: CONTACT PHONE:425-885-4300 TOM PIKE (MAGELLAN ARCHITECTS) CONTACT EMAIL:tom@magellanarchitects.com BUILDING INFORMATION VALUATION OF WORK: $230.600.00 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:B-BUSINESS (OFFICE) PROPOSED USE OF BUILDING:B-BUSINESS (MEDICAL/DENTAL OFFICE-CLINIC) 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 ETA. ❑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: 2,306 S.F. INTERIOR OFFICE T.I. REMODEL AT GROUND LEVEL (SUITE K) OF 1-STORY STRUCTURE. SCOPE OF WORK INCLUDES NEW INTERIOR PARTITIONS, DOORS, AND CASEWORK; NEW DOOR ADDED ON NORTH SIDE OF BUILDING. OCCUPANCY CLASSIFICATION TO REMAIN 'B'. 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#^/ Tom P/e - - 12/20/2021 `2— Owner/Authorized Agent Signature Date (Revised 2/8/2021) )/