910 SE EVERETT MALL WAY PEARLE VISION 2024-06-21

E . S BUILDING PERMIT APPLICATION 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 910 SE Everett Mall Way PARCEL#: c!Ty Everett STATE WA ZIP 98208 SUITE/UNIT#: 103 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Pearle Vision LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Rands 910 Center LLC OWNER MAILING ADDRESS: STREET 15015 Main Street, Suite 203 CITY Bellevue STATE WA ZIP 98007 OWNER PHONE:425-745-5055 OWNER EMAIL: blake@pmfinvestments.com CONTRACTOR COMPANY NAME:TBD WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER LI CONTRACTOR ❑✓ OTHER(Please Specify) Agent for tenant CONTACT NAME: CONTACT PHONE:952-345-6040 Tim Schenk CONTACT EMAIL:tims@elderjones.com BUILDING INFORMATION VALUATION OF WORK: $267000.00 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:Mercantile PROPOSED USE OF BUILDING:MerCantile HEAT SOURCE: ❑Gas ❑Electric ❑Other �/ BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: QCommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑✓Remodel ❑Repair [1T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ETank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: DESCRIPTION OF WORK:Remodel of the former T Mobile store into a new Pearle Vision Center. Work to include interior non structural demo, new partitions, doors, hardware, finishes, & store fixtures. • , uticts, switchcs a- -- micc. low voltage. ivy- w� ' pvm 1f • 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only �C I Lk‘ 20\, PER (>516 Owner/Authorized Agent Signature Date (Revised 2/8/2021) I/ Z