11802 EVERGREEN WAY 101 WOODS COFFEE 2024-06-21

Nom BUI•NG PERMIT APPLICATIc CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL 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)PermitServices@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 11802 Evergreen Way PARCEL#: 00442900402401 cm, Everett STATE WA ZIP 98204 SUITE/UNIT#: 101 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): N/A TENANT/BUSINESS NAME(if non-residential):Woods Coffee inc. LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Existing Lot No.: N/A (attach copy of long legal description) CONTACT INFORMATION OWNER NAME I lt) I OWNER MAILING ADDRESS: STREET 1• -L-18T-H-SF---- CITY_�- STATE ^ ZIP -982b4- OWNER PHONE:66 2:$27 OWNER EMAIL TA-YtO WOODSC0FF€ECOM ':'tr'k CONTRACTOR COMPANY NAME:Woods Coffee inc. j\)'1-�j `'— G�y'i�� j'►'`T� WA STATE CONTRACTOR LICENSE#(REQUIRED):Over-Contractor ,CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) CONTRACTOR ADDRESS: STREET 191 18th St. CITY Lynden STATE WA ZIP 98264 CONTRACTOR PHONE:360-592-8272 CONTRACTOR EMAIL:taylorh@woodscoffee.com PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) ' S2J13 A-N I CONTACT NAME: CONTACT PHONE:360-592-8272 Taylor Herman CONTACT EMAIL:taylorh@woodscoffee.com BUILDING INFORMATION VALUATION OF WORK: $250,000 ASSOCIATED LAND USE PROJECT#(if applicable):N/A (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Drive-through coffee cafe PROPOSED USE OF BUILDING:Drive-through coffee cafe HEAT SOURCE: ❑✓Gas ❑Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair 1E11 ❑Change of Use ❑Modular [Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage LPool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK: Remodel former coffee cafe with drive-thru space for a new coffee cafe with drive-thru. same general layout new look. �� n 4'1:�; ID) v EO DEC 0 8 2023 CITY ..O„„��F c�F\/FRFTT ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work doiref, lr�rtt$tlafWJrfr PArist 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!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Digitally signed by Taylor Herman PERMIT# 'Woods ou c.US"E-taylor anagercoifeecnm HermanOcWoo sDdttee 12/7/2023 �� DD=CDD Project Manager document Herman Reason'I am approving this document COFFEE Dale'2023.12.0712:2]:a7-OB'00' Owner/Authorized Agent Signature Date (Revised 4/21/2022)