8531 EVERGREEN WAY COMMUNITY HEALTH CENTER 2025-05-28

Elm BU )ING PERMIT APPLICATI I 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 8531 Evergreen Way PARCEL#: 28041300103100 CITY Everett STATE WA ZIP 98208 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Community Health Center of Snohomish County LEGAL DESCRIPTION for new construction: Short Plat/subdivision: ANF 7801120300 Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Community Health Center of Snohomish County OWNER MAILING ADDRESS: STREET 8609 Evergreen Way CITY Everett STATE WA ZIP 98208 OWNER PHONE:425.789.3800 OWNER EMAIL: dkapetanov@chcsno.org CONTRACTOR COMPANY NAME:Aldrich &Associates, INC. WA STATE CONTRACTOR LICENSE#(REQUIRED):ALDRIA`202RU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 39375 CONTRACTOR ADDRESS: STREET810 240 St. SE CITY Bothell STATE WA ZIP 89021 CONTRACTOR PHONE:425.483.1919 CONTRACTOR EMAIL:mdaumen@aldrich-assoc.com PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.823.2244 Janet L. Monda CONTACT EMAIL:janet@awerks.com Cc: ryan@awerks.com (Ryan O. 'vie) BUILDING INFORMATION VALUATION OF WORK:$5 2C�000 N UC7CJ ASSOCIATED LAND USE PROJECT#(if applicable):TBD, (Valuation shall include the prellifil fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: PROPOSED USE OF BUILDING:Business, office HEAT SOURCE: ❑Gas lElectric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: OCommercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ONew Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑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:THE PROJECT CONSISTS OF A NEW TWO STORY BUILDING FOR USE AS AN OFFICE BUILDING ON A VACANT SITE. SITE WORK CONSISTS OF PARTIAL SITE CLEARING AND RE-GRADING,NEW UTILITY SERVICE RUNS AND CONNECTION,EXPANDED PARKING,NEW BUILDING FOUNDATION,LANDSCAPE AND IRRIGATING,AND SURFACE WATER RUNOFF CONTROL. BUILDING WORK CONSISTS OF METAL SIDING AND STONE VENEER INSULATED WOOD STUD EXTERIOR WALLS,CONTINUOUSLY INSULATED ROOF,ALUMINUM STOREFRONT DOORS AND WINDOWS,STEEL AWNINGS,GYP.WALLBOARD METAL STUD WALL PARTITIONS,WOOD MILLWORK,WOOD DOORS,CARPET TILE FLOORING,ACOUSTIC CEILING PANEL GRID SYSTEM,ELECTRICAL,MECHANICAL,PLUMBING,FIRE-LIFE SAFETY AND FIRE SUPPRESSION SYSTEMS AS REQUIRED PER ROOM CONFIGURATION. ELECTRICAL,MECHANICAL,PLUMBING,FIRE-LIFE SAFETY,FIRE ALARM,AND FIRE SUPPRESSION SYSTEMS TO BE BIDDER DESIGNED&SUBMITTED AS A SEPARATE DEFERRED SUBMITTAL. SIGNAGE AND LOW-VOLTAGE DATA AND SECURITY TO BE BY OWNER'S REPRESENTATIVE&SUBMITTED AS A SEPARATE DEFERRED SUBMITTAL. 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 Digitally signed by p p.Ryan 0 Ivie,Janet L.Monda ON.C=US,E=ryan@awerks.corn,O=Architectural q C O PERMIT# s'f p.p. Ryan O. Ivie,Janet L. Monda Werks INC.,OU=Architect,CN="p p.Ryan 0!vie, 02/1 6/2023 tl3 / 2 0 � -- 0 Janet L.Monda" ��// [/,� ./] VV Date:2023.02.16 07.40-45-08'00' Owner/Authorized Agent Signature Date (Revised 4/21/2022)