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BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> 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 1(E)PermitServices@everettwa.gov i(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 607 SE Everett Mall Way PARCEL#: <br /> c,n Everett STATE WA ZIP 98208 <br /> SUITE/UNIT#: 7 FLOOR M 1 ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Midnight Cookie Co. /Paul Quinn <br /> LEGAL DESCRIPTION for new construction_ Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:NW Properties/Alex Jo <br /> OWNER MAILING ADDRESS: STREET 6947 Coal Creek Pkwy SE <br /> CITY Newcastle STATE WA z,P 98059 <br /> OWNER PHONE:2062265678 1OWNER EMAIL: alex@nwprime.com <br /> CONTRACTOR COMPANY NAME:Paul Quinn (Tenant with Owner Authorization) <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET607 SE Everett Mall Way Suite 7 <br /> CITY Everett` STATE WA z,P 98208 <br /> CONTRACTOR PHONE:206 595-3149 1CONTRACTOR EMAIL:admin@mldnlghtcookieco.COm <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) Tenant <br /> CONTACT NAME: CONTACT PHONE:206 595-3149 <br /> Paul Quinn CONTACT EMAIL:admin@midnightcookieco.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$$250 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: Food service <br /> PROPOSED USE OF BUILDING:Food service <br /> HEAT SOURCE: ❑Gas ✓❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): [I New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Mot Tub ❑Tank(above ground) ✓❑Other: Fixture move <br /> DESCRIPTION OF WORK:Move handwash sink to other side of wall to using existing surface mounted water and <br /> drain lines. Extend water and drain lines along wall to accomodate ice machine <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 r_ ntin 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 authdnzed under any c stance.f 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 Conti tors Law 18.27 RCW an�96.200A WAC. <br /> �' City of Everett Official Use Only <br /> _ PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />